Clinical Audit Manager

Clinical Audit Manager

This is an exciting opportunity to work for a leader of resources for payors solutions & bill review with a preferred client. General essential functions include performing DRG validation (clinical/coding) reviews of medical records and/or other documentation to determine the correct DRG/coding that is clinically supported as defined by review methodologies specific to the contract for which review services are being provided. This involves completing medical records review, accurately documenting findings and non-findings, and providing clinical/policy/regulatory support for the determination.

Requirements:

• Must have CCS, CIS, CPC, or CMAS


• Extensive hands-on ICD-10 CM / PCS experience required.


• 3+ years recent experience in auditing or compliance


• Previous internal or external audit experience


• 5+ years clinical experience

Benefits:

• Paid Time Off (PTO)


• Major Holidays


• Medical, Dental and Vision insurance


• Wellness Programs


• Flexible Spending Accounts Medical, Dependent Care, and Transportation


• 401K with Discretionary Company Match


• Long-Term and Short-Term Disability


• Basic Life & AD&D Insurance

Who We Are

Headquartered in Central Florida, Pivotal Placement Services is a full-service national workforce solutions firm that specializes in placing healthcare professionals from staff to leadership with both clinical and non-clinical employers. Our Comprehensive and Customer Focused Workforce Solutions include, Direct Placement, and Managed Service Provider (MSP) / Vendor Managed Services (VMS) engagements nationally. Pivotal Placement Services is an Equal Opportunity Employer