Texas Licensed Clinical Review Supervisor

Job Summary

A company is looking for a Clinical Review Supervisor.

Key Responsibilities

• Supervises daily activities of the DRG Clinical Auditors
• Completes DRG audits and ensures the integrity of diagnosis and procedure codes
• Holds DRG Clinical Auditors accountable for quotas and error/accuracy rates

Required Qualifications and Education

• N./L.V.N. preferred; CCS or CIC required with DRG auditing experience
• Minimum of 3-5 years of inpatient/DRG auditing experience in a hospital or payer setting
• At least 2 years of supervisory experience with clinical auditors
• Proficient in Medicare, CMS guidelines, and ICD-10 coding guidelines
• Experience with claims denials and appeals required