Clinical Quality Analyst

Job Summary

Seeking an experienced Clinical Quality Analyst, the remote position will oversee the accuracy of clinical Diagnosis-Related Group (DRG) audits, mentor auditors, and recommend process improvements while ensuring compliance with company standards.

Key responsibilities

• Apply clinical judgment for DRG audits to ensure accuracy of inpatient DRG coding
• Review the accuracy and consistency of clinical DRG auditing to ensure proper documentation of findings
• Mentor Clinical DRG auditors and recommend process changes to enhance quality and performance

Required qualifications

• Minimum 5 years of experience with clinical validation audits
• Thorough understanding of medical terminology and human physiology
• Superior auditing and monitoring skills
• Strong technical knowledge and ability to learn new systems quickly
• Excellent decision-making skills and sound judgment