Certified Recovery Consultant

Job Summary

A company is looking for a Recovery Resolution Consultant.

Key Responsibilities

• Perform DRG validation reviews and confirm appropriate DRG assignments
• Investigate and provide clinical expertise in medical records review for claim adjudication
• Serve as a Subject Matter Expert in Payment Integrity initiatives and identify trends in coding practices

Required Qualifications

• High School Diploma / GED or equivalent work experience
• Certified coder with AHIMA or AAPC (e.g., RHIA, RHIT, CPC, CIC)
• 5+ years of experience in the health insurance industry
• 2+ years of experience with inpatient DRG coding and medical records review
• Proficiency in performing financial analysis/audits