Clinical Auditor - State Licensed

A company is looking for an Auditor Clinical Validation DRG. Key Responsibilities Analyze and audit inpatient claims, integrating medical chart 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 (RHIA, RHIT, CPC, CCS, CIC, CDIP, or CCDS) required 5 to 7+ years of experience with ICD-9/10CM, MS-DRG, AP-DRG, and APR-DRG Expert knowledge of coding guidelines and compliance regulations Proficiency in relevant software applications such as Word, Access, and Excel

Jun 21, 2025 - 11:30

A company is looking for an Auditor Clinical Validation DRG. Key Responsibilities Analyze and audit inpatient claims, integrating medical chart 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 (RHIA, RHIT, CPC, CCS, CIC, CDIP, or CCDS) required 5 to 7+ years of experience with ICD-9/10CM, MS-DRG, AP-DRG, and APR-DRG Expert knowledge of coding guidelines and compliance regulations Proficiency in relevant software applications such as Word, Access, and Excel