RN Licensed Nurse Coder Auditor

Job Summary

A company is looking for a Nurse Coder DRG Auditor I (US Remote).

Key Responsibilities

• Utilize coding and clinical guidelines to perform DRG validation and evaluate medical necessity
• Validate diagnoses and procedures using medical records and apply relevant coding standards
• Assist with claim selection criteria and provide appeal responses based on industry standards

Qualifications

• An active RN professional license in good standing
• 5 years of clinical practice experience
• Coding certification in good standing (e.g., CCS, CPC, CIC)
• 2-5 years of coding validation/auditing experience
• Experience with Microsoft Office, specifically Excel