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Clinical Validation Auditor

VirtualVocations
Alpharetta, Georgia, United States
Full-time

A company is looking for an Auditor Clinical Validation DRG to focus on coding and clinical chart validation for inpatient audits.

Key ResponsibilitiesAnalyze and audit claims using medical chart coding principles and clinical guidelinesUtilize proprietary auditing systems to make determinations and generate audit lettersMaintain productivity and accuracy standards set by the audit operations management teamRequired Qualifications and EducationAssociate or bachelor's degree in nursing (active / unrestricted license) or Health Information Management (RHIA or RHIT)Coding / CDI certification such as RHIA, RHIT, CPC, CCS, CIC, CDIP, or CCDS5 to 7+ years of experience with ICD-9 / 10CM, MS-DRG, AP-DRG, and APR-DRGExpert knowledge of coding guidelines, CMS regulations, and medical necessity criteriaProficiency in Word, Access, Excel, and TEAMS

5 days ago
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