New Jersey Licensed Clinical Auditor

Job Summary

To support healthcare auditing needs, the full-time Clinical DRG Validation Auditor will lead audits of hospital billing and coding practices, develop audit forms, and provide guidance on ICD 10 CM and DRG assignment, all while working remotely from New Jersey, Pennsylvania, or New York.

Key responsibilities

• Identify and present billing errors found during audits and coordinate referrals for improper claim payments
• Compile audit statistics and prepare reports for accounts, regulatory agencies, and internal teams
• Train new team members on audit procedures and departmental workflows

Required qualifications

• Active RN license and CCS certification
• Minimum 3 years of experience in a medical records department within an acute care hospital or similar healthcare facility
• Experience with DRG validation, ICD 10 CM training, and coding education
• Strong computer skills, including Microsoft Excel, Word, and PowerPoint