Remote Clinical Validations Audit Lead Assistant Manager

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