job description - Medical Case Auditor
- Review the case-note of clients in assigned hospital, to ensure that treatment provided aligns with the in house coverage determination criteria.
- Escalate and document any claim(s) that are fraudulent, waste or appear to be abuse of insurance principles.
Job Specification
- Candidate must be a Registered Nurse (RN), Registered Midwife (RM), or holder of BSc Nursing, First (BScN) Degree
- Must be resident in the states required for the role
- Ability to work in a team.
- Ambitious and target focused with a drive to succeed.
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