Job Summary
A digital analytics company is searching for a person to fill their position for a Remote Clinical Validations Audit Lead Assistant Manager.
Individual must be able to fulfill the following responsibilities:
- Review Clinical Validation provider appeals reviews to verify the accuracy of the MS-DRG assignment
- Meet or exceed company established program productivity and quality goals
- Work independently with passion and drive towards excellence
Must meet the following requirements for consideration:
- Associate or Bachelor’s degree in nursing (active / unrestricted license)
- 5+ years of experience with MS DRG with expert knowledge of AHA Coding Guidelines
- Experience with DRG encoder tools (3M, Webstrat, Pricers)
- Strong clinical & analytical skills, with attention to detail
- Prior experience managing and responding to provider Clinical Validation appeals
- 5 years of clinical nursing experience in the inpatient setting
