Clinical Audit Specialist

1 week ago


Houston, Texas, United States GHR RevCycle Workforce Full time
Position Overview

The ideal candidate for this role is a Registered Nurse with a strong background in critical care settings.

Experience with EPIC systems is highly desirable, along with a robust clinical auditing background.

Essential Qualifications
Education: A Bachelor’s degree in Nursing is required, while a Master’s degree in Business or Healthcare Administration is preferred.
Licenses/Certifications: Must possess a current and valid Registered Nurse license in Texas.
Experience / Knowledge / Skills:
    • A minimum of five (5) years of experience in finance, operations, auditing, or consulting within a hospital or managed care environment.
    • At least five (5) years of clinical experience, ideally in critical care.
    • Familiarity with the standards set by the American Association of Medical Audit Specialists and TJC Core Measures as applicable.
    • Understanding of Medicare and Medicaid regulations.
    • Exceptional analytical, critical thinking, communication, and interpersonal abilities.
    • Proficient in PC applications, including Word, Excel, and Access.
    • Experience in application development and a solid understanding of ERP software (e.g., Lawson, SAP, etc.) is highly advantageous.


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