Clinical Auditor RN

A company is looking for an Auditor Clinical Validation DRG. Key Responsibilities Analyze and audit inpatient claims, integrating medical coding principles and clinical guidelines Utilize proprietary auditing systems to make determinations and generate audit letters Meet productivity and accuracy standards set by the audit operations management team Required Qualifications Associate or bachelor's degree in nursing or Health Information Management (RHIA or RHIT) Coding/CDI certification such as RHIA, RHIT, CPC, CCS, CIC, CDIP, or CCDS 5 to 7+ years of experience with ICD-9/10CM, MS-DRG, AP-DRG, and APR-DRG Expert knowledge of coding guidelines and medical claims billing/payment systems Proficiency in Word, Access, Excel, TEAMS, and other applications

Apr 11, 2025 - 15:32

A company is looking for an Auditor Clinical Validation DRG. Key Responsibilities Analyze and audit inpatient claims, integrating medical coding principles and clinical guidelines Utilize proprietary auditing systems to make determinations and generate audit letters Meet productivity and accuracy standards set by the audit operations management team Required Qualifications Associate or bachelor's degree in nursing or Health Information Management (RHIA or RHIT) Coding/CDI certification such as RHIA, RHIT, CPC, CCS, CIC, CDIP, or CCDS 5 to 7+ years of experience with ICD-9/10CM, MS-DRG, AP-DRG, and APR-DRG Expert knowledge of coding guidelines and medical claims billing/payment systems Proficiency in Word, Access, Excel, TEAMS, and other applications