CVA Auditor III

A company is looking for a Clinical Validation Auditor III. Key Responsibilities Conduct clinical reviews to verify the accuracy of DRG assignments and reimbursements Document audit results using clinical guidelines and coding rules Utilize proprietary tools to make audit determinations and generate audit rationales Required Qualifications Registered Nurse with an Associate's or Bachelor's degree 5+ years of acute care nursing experience, preferably with clinical or coding validation audit experience Experience with DRG retrospective overpayment identification auditing preferred Prior readmission auditing experience is a plus Preference for candidates with CCS, RHIA, or RHIT coding credentials

Apr 2, 2025 - 00:17

A company is looking for a Clinical Validation Auditor III. Key Responsibilities Conduct clinical reviews to verify the accuracy of DRG assignments and reimbursements Document audit results using clinical guidelines and coding rules Utilize proprietary tools to make audit determinations and generate audit rationales Required Qualifications Registered Nurse with an Associate's or Bachelor's degree 5+ years of acute care nursing experience, preferably with clinical or coding validation audit experience Experience with DRG retrospective overpayment identification auditing preferred Prior readmission auditing experience is a plus Preference for candidates with CCS, RHIA, or RHIT coding credentials