Nurse Auditor

New
  • Location
    Wausau, Wisconsin
  • Job type
    Contract/Temporary
  • Category
    Medical & Science - Nursing

A Clinical Nurse Auditor position in Wausau, WI is now available courtesy of Adecco Medical & Science. Candidates must be a licensed Registered Nurse in WI and a minimum of 5 years of combined experience working with federal (e.g., Joint Commission, AAAHC) and state health and safety standards, experience working in a regulatory and/or compliance role in the healthcare or health insurance industries, leading and implementing a comprehensive compliance program, experience working with HIPAA and state privacy laws.

This position offers a competitive pay rate and benefits package.

As a Clinical Nurse Auditor you will be responsible for supporting all aspects of the compliance program with focus on practice health and safety compliance.


Job duties for the Clinical Nurse Auditor include:

1.Review Appeals and Provider Inquiries for clinical eligibility for coverage as prescribed by the Plan benefits.

2. Works within DOL and State guidelines.

3. Reviews and interprets Plan language appropriately.

4. Utilizes clinical guidelines and criteria appropriately.

5. Responsible for accurately documenting determinations.

Monday through Friday 8am-4:30pm CST

If you are interested in this Nurse Auditor position in the Wausau, WI area please contact Ashley Gruver at ashley.gruver@adeccona.com or apply online by clicking on APPLY NOW. For other great healthcare opportunities at Adecco Medical & Science, go to www.adeccousa.com
Equal Opportunity Employer Minorities/Women/Veterans/Disabled

  • Apply with Adecco

Reference number US_EN_2_101084_330546