Job Summary

A management and recovery solutions company is searching for a person to fill their position for a Telecommuting Medical Review Nurse Auditor.

Core Responsibilities Include:

• Conducting medical chart reviews
• Clinically validating the medical appropriateness and coding accuracy of services rendered in an inpatient setting
• Making determinations based on clinical expertise and knowledge while using audit tools and resources available

Must meet the following requirements for consideration:

• Knowledgeable of the uses of ICD-9, ICD-10 PCS/HCPCS/CPT, MS-DRG codes
• Familiarity with interpreting electronic medical records (EHR)
• Knowledge of insurance programs, particularly the coverage and payment rules
• Ability to maintain high quality work while meeting deadlines and performance metrics
• Active unrestricted RN license in good standing
• 2+ years clinical review and coding/auditing experience for an inpatient facility