Clinical Auditor DRG

Job Summary

A company is looking for an Auditor Clinical Validation DRG.

Key Responsibilities

• Analyze and audit inpatient claims using medical chart coding principles and clinical guidelines
• Utilize proprietary auditing systems to make determinations and generate audit documentation
• Maintain productivity and quality standards set by audit operations management

Required Qualifications

• Associate or bachelor's degree in nursing or Health Information Management (RHIA or RHIT), or equivalent experience with a high school diploma
• Certification in coding/CDI (RHIA, RHIT, CPC, CCS, CIC, CDIP, or CCDS) required
• 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 applications such as Word, Access, Excel, and TEAMS