Registered Nurse Clinical Auditor

Job Summary

To ensure the accuracy of inpatient DRG coding, the remote Quality Analyst IV - Clinical Validation Auditor will oversee the work of Clinical CVA auditors, conduct quality reviews of clinical audits, and mentor auditing staff.

Key responsibilities

• Apply clinical judgment for DRG audits to ensure accuracy of inpatient DRG coding
• Review the accuracy and consistency of clinical DRG auditing to ensure proper marking of findings
• Mentor Clinical DRG auditors and recommend process improvements for quality and performance

Required qualifications

• Current Registered Nurse license
• 5+ years of experience with clinical validation audits
• Thorough understanding of medical terminology and human physiology
• Strong technical knowledge and ability to learn new systems quickly
• Excellent decision-making skills and sound judgment