Clinical Validation Auditor - Coding and Documentation

POSITION SUMMARY

The Clinical Validation Auditor performs clinical validation and audit reviews, drafting and processing 

appeals for denials, and reporting trends discovered working collaboratively as a key member of a 

multidisciplinary team

PRIMARY ACCOUNTABILITES

all diagnoses and procedure codes reported and that it upholds regulatory compliance by 

consulting and referencing validated coding and documentation references for accurate code 

assignment and sequencing rules.

2. Composes appeal letters to governmental and private payers on denials received with clear and 

effective communication, to include appropriate references, in the validation of the clinical 

diagnoses as documented in the clinical record; process appeal letters to payers designated