Clinical Auditor DRG

Job Summary

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