Clinical Auditor DRG

A company is looking for an Auditor Clinical Validation DRG.

Key Responsibilities

Analyze and audit inpatient claims, integrating medical coding principles and clinical guidelines

Utilize proprietary auditing tools to make audit determinations and generate documentation

Meet productivity and quality standards set by management while identifying potential new claim types

Required Qualifications

Associate or bachelor's degree in nursing or Health Information Management (RHIA or RHIT) or equivalent experience

Active coding / CDI certification such as RHIA, RHIT, CPC, CCS, CIC, CDIP, or CCDS

5 to 7+ years of experience with ICD-9 / 10CM, MS-DRG, AP-DRG, and APR-DRG

Expert knowledge of coding guidelines and compliance regulations

Proficiency in Microsoft Office applications and relevant auditing tools