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QuadMed

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Supv, Clinical Nurse Auditor
Position SummaryThis position provides comprehensive assessment, coordination, implementation and reporting of complex clinical data. This position audits medical records on behalf of hospital clients for denials review, defense audits, disallowed charges and retrospective or concurrent reviews. The Supervisor NA, leads and supports the enterprise in utilization management through denials prevention and denials management. The Supervisor, NA brings expert analysis of medical records to inpatient and outpatient claims, assesses the patient’s plan of care and progress of the patient throughout an acute care admission. The intensity of assessment is situational and appropriate based on payer requirements. This position works independently receiving supervision of work activities


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