Texas Licensed Clinical Quality Auditor

Job Summary

Seeking a Texas Licensed Clinical Quality Auditor, Sr. Specialist for a remote, full-time position responsible for conducting quality assurance audits of outpatient coding and DRG validation, ensuring accuracy and compliance with coding guidelines.

Key responsibilities

• Perform quality assurance audits of medical records to ensure accurate coding and compliance with clinical guidelines
• Identify quality trends and develop corrective interventions while leading training initiatives for clinical and coding staff
• Document review determinations and results clearly for trending and reporting purposes

Required qualifications

• Active, unrestricted RN licensure in the United States and state of primary residence
• Associates degree required; bachelor's degree preferred
• 3+ years of experience in MS DRG/APR DRG coding or outpatient auditing
• Expert knowledge of ICD-10-CM and ICD-10-PCS coding methodologies
• One of the following coding certifications preferred: RHIA, RHIT, CCS, CIC, CPMA, CCDS, or CPC