Job Summary
A health insurance company is filling a position for a Telecommute Clinical Documentation Improvement Specialist.
Core Responsibilities of this position include:
- Performing DRG validation reviews and confirm appropriate diagnosis related group assignments
- Maintaining current working knowledge if ICD-10 coding principles and CMS regulations
- Investigating, reviewing, and providing clinical or coding expertise in the application of medical and reimbursement policies
Skills and Requirements Include:
- Inpatient Coder with RHIT, RHIA or CCS Certifications
- 5+ years of experience in the health insurance industry
- 2+ years of experience with health insurance claims
- 2+ years with medical records review/auditing
- 2+ years of experience in using claims platforms such as UNET, Pulse, NICE, Facets, Diamond, etc
- Proficiency in performing financial analysis/audit including statistical calculation and interpretation
