Minnesota Licensed Clinical Auditor RN

Job Summary

Utilizing expert knowledge in MS-DRG and APR-DRG coding methodologies, the full-time Minnesota Licensed Clinical Auditor RN will conduct audits of inpatient claims, validate coding accuracy, and identify overpayments while working remotely from anywhere in the U.S.

Key responsibilities:

• Conduct MS-DRG and APR-DRG coding reviews to verify accuracy and identify overpayments
• Utilize expert knowledge to ensure correct ICD-10-CM/PCS code assignments and compliance with coding guidelines
• Write clear rationales supporting audit findings based on coding guidelines and clinical criteria

Required qualifications:

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