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RHIT Licensed Recovery Consultant
A company is looking for a Recovery Resolution Consultant - National Remote. Key Responsibilities Perform DRG validation reviews and confirm appropriate diagnosis related group (DRG) assignments Investigate and provide clinical and coding expertise in the claim adjudication process through medical records review Serve as a Subject Matter Expert (SME) for Payment Integrity initiatives, including identifying overpayments and supporting recovery strategies Required Qualifications Inpatient Coder with RHIT, RHIA or CCS Certification(s) 5+ years of experience in the health insurance industry 2+ years of experience with health insurance claims 2+ years of experience with medical records review/auditing, including MS-DRG coding validation Proficiency in using claims platforms such as UNET, Pulse, NICE, etc
A company is looking for a Recovery Resolution Consultant - National Remote.
Key Responsibilities
Perform DRG validation reviews and confirm appropriate diagnosis related group (DRG) assignments
Investigate and provide clinical and coding expertise in the claim adjudication process through medical records review
Serve as a Subject Matter Expert (SME) for Payment Integrity initiatives, including identifying overpayments and supporting recovery strategies
Required Qualifications
Inpatient Coder with RHIT, RHIA or CCS Certification(s)
5+ years of experience in the health insurance industry
2+ years of experience with health insurance claims
2+ years of experience with medical records review/auditing, including MS-DRG coding validation
Proficiency in using claims platforms such as UNET, Pulse, NICE, etc