Registered Nurse Clinical Auditor

Job Summary

Seeking a detail-oriented Registered Nurse Clinical Auditor, the fully remote position will review inpatient medical records to validate DRG codes, apply clinical judgment to identify inaccuracies and potential overpayments, and document findings professionally.

Key responsibilities

• Review inpatient medical records to verify accuracy of DRG codes based on documentation
• Apply clinical and coding knowledge to identify inaccuracies and potential overpayments
• Document findings clearly and professionally, explaining the rationale behind reviews

Required qualifications

• Active Registered Nurse (RN) license
• 5+ years of acute care experience in a hospital setting
• Experience in DRG audits or coding validation is preferred
• Certifications such as CCS, RHIA, or RHIT are a plus
• Knowledge of readmission reviews (PPR) is advantageous