Texas Licensed Payment Integrity Analyst

A company is looking for a Payment Integrity Analyst II - DRG Auditor.

Key Responsibilities

Review and complete internal audits and appeals based on client policies and CMS guidelines

Utilize clinical judgment to analyze documentation for claim audits

Attend meetings and complete additional assigned duties as necessary

Required Qualifications and Education

Current LPN, LVN, or RN licensure is required

Preferred experience with health insurance denials, payer audits, or vendor audits

1+ years of experience in healthcare revenue cycle and hospital bill auditing

Bachelor's degree in healthcare or related field preferred

Experience in acute clinical areas such as O.R., I.C.U., or E.R. is beneficial