New York Licensed Clinical Validation Nurse

Job Summary

A company is looking for a DRG Clinical Validation Nurse.

Key Responsibilities

• Perform clinical validation to ensure diagnosis codes are supported by medical records
• Interpret clinical guidelines and apply them to clinical reviews
• Maintain and manage case reviews with a focus on quality in a high-volume environment

Required Qualifications

• Minimum of two years' experience in clinical validation in a payment integrity setting
• Unrestricted Registered Nurse with active RN licensure
• CCS or CIC certification preferred
• Knowledge of ICD-10 coding and basic understanding of DRG validation
• Ability to use a Windows PC and multiple applications simultaneously