Remote Clinical Claim Review RNVirtualVocations • Newark, Delaware, United States
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Remote Clinical Claim Review RN
VirtualVocations • Newark, Delaware, United States
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A company is looking for a Sr. Clinical Claim Review RN.
Key Responsibilities
Conduct MS-DRG and APR-DRG coding reviews to verify accuracy and identify overpayments
Perform clinical coding reviews ensuring accuracy and compliance with coding guidelines
Utilize proprietary workflow systems to manage daily case reviews and audit determinations
Required Qualifications
Unrestricted RN (registered nurse) license
CCS / CIC certification
3+ years of MS DRG / APR DRG coding experience in a hospital environment
Expert knowledge of ICD-10 Official Coding Guidelines and DRG reimbursement methodologies
Expert knowledge of ICD-10-CM and ICD-10-PCS coding components
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Clinical Review • Newark, Delaware, United States
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