Job Details

A company is looking for an Auditor Clinical Validation DRG.Key ResponsibilitiesAnalyze and audit inpatient claims, integrating medical chart coding principles and clinical guidelinesUtilize proprietary auditing systems to make audit determinations and generate audit lettersMeet or exceed productivity and accuracy standards set by audit operations managementRequired QualificationsAssociate or bachelor's degree in nursing or Health Information Management (RHIA or RHIT), or equivalent experience in claims auditingActive coding/CDI certification (RHIA, RHIT, CPC, CCS, CIC, CDIP, or CCDS)5 to 7+ years of experience with ICD-9/10CM, MS-DRG, AP-DRG, and APR-DRGExpert knowledge of coding guidelines and regulatory complianceProficiency in Word, Access, Excel, TEAMS, and other applications