Clinical Validation Auditor

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 letters
• Meet or exceed productivity and accuracy standards set by management

Required Qualifications

• Associate or bachelor's degree in nursing or Health Information Management (RHIA or RHIT)
• Certification in coding/CDI (e.g., RHIA, RHIT, CPC, CCS, CIC, CDIP, CCDS)
• 5 to 7+ years of experience with ICD-9/10CM, MS-DRG, AP-DRG, and APR-DRG
• Proficiency in Word, Access, Excel, TEAMS, and other applications
• Adherence to official coding guidelines and regulatory compliance