DRG Auditor RN

Job Summary

A company is looking for a DRG CVT RN Auditor to conduct coding and clinical audits for inpatient claims.

Key Responsibilities

• Conduct MS-DRG and APR-DRG coding reviews to verify accuracy and identify overpayments
• Utilize expert knowledge to ensure proper ICD-10-CM/PCS code assignment and compliance with guidelines
• Write clear rationales supporting audit findings and manage daily case review assignments

Required Qualifications

• Associate's Degree or higher
• Unrestricted RN (Registered Nurse) license
• CCS/CIC certification or willingness to obtain within 6 months of hire
• 3+ years of MS DRG/APR DRG coding experience in a hospital environment
• 2+ years of ICD-10-CM and ICD-10-PCS coding experience