Clinical Validation Auditor

A company is looking for a Sr Auditor TL, Clinical Validation. Key Responsibilities: Analyze and audit inpatient claims for coding accuracy and clinical appropriateness Utilize proprietary auditing tools to make accurate audit determinations and generate audit letters Meet or exceed productivity and quality standards in all audit work Required Qualifications: Associate or Bachelor's degree in Nursing or Health Information Management with relevant certification Active coding/CDI certification such as RHIA, RHIT, CPC, COC, CCS, CIC, CDIP, or CCDS 5 to 7+ years of experience with ICD-9/10CM, MS-DRG, and medical claims billing systems Expert knowledge of coding guidelines and compliance regulations Proficiency in Microsoft Office applications

Apr 10, 2025 - 16:14

A company is looking for a Sr Auditor TL, Clinical Validation. Key Responsibilities: Analyze and audit inpatient claims for coding accuracy and clinical appropriateness Utilize proprietary auditing tools to make accurate audit determinations and generate audit letters Meet or exceed productivity and quality standards in all audit work Required Qualifications: Associate or Bachelor's degree in Nursing or Health Information Management with relevant certification Active coding/CDI certification such as RHIA, RHIT, CPC, COC, CCS, CIC, CDIP, or CCDS 5 to 7+ years of experience with ICD-9/10CM, MS-DRG, and medical claims billing systems Expert knowledge of coding guidelines and compliance regulations Proficiency in Microsoft Office applications