Health Srvcs Auditor-Documentation Specialist
Job Number 144535
This position documents and audits SelectHealth Health Services care and utilization management processes, procedures and guidelines to ensure staff meet appropriate standards in care and utilization management standards of practice, which are in line with regulatory standards (NCQA, federal and state), and benefit structure of employer contracts. This position helps to ensure appropriate care and utilization management for SelectHealth members, Superior Service to all internal and external customers, and the responsible use of company financial resources.
Registered Nurse with a current license to practice in the State of Utah.
A bachelor’s degree in nursing or health insurance related field
Certified Case Manager (CCM) designation must be achieved within 12 months of hire/transition into this position.
Two years of broad clinical care management experience in a health insurance environment.
Demonstrated excellent written and verbal communication skills, which demonstrates the employee’s ability to effectively communicate with other employees and members.
Able to demonstrate intermediate computer proficiency in Windows, word processing and spreadsheet software.
Able to work independently and be self-motivated with a positive attitude and flexibility in a rapidly changing environment.
SelectHealth Care Management experience
Experience auditing workflows, processes, and documentation in a clinical setting.
Good understanding of ICD-9/CPT 4 and ICD-10 coding principles.
Job Type: Full Time
Location: Murray, UT, US