Texas Licensed Payment Integrity Analyst

Job Summary

A company is looking for a Payment Integrity Analyst II - DRG Auditor.

Key Responsibilities

• Review and analyze internal audits and appeals according to client policies and CMS guidelines
• Utilize clinical judgment to interpret documentation for claim audits effectively
• Complete audits and appeals in a timely manner and attend relevant meetings and trainings

Required Qualifications, Training, and Education

• Current LPN, LVN, and/or RN licensure is required
• Preferred experience with health insurance denials, payer audits, or vendor audits
• 1+ years of healthcare revenue cycle experience and hospital bill auditing
• Bachelor's degree in healthcare or a related field is preferred
• Experience in acute clinical areas such as O.R., I.C.U., E.R., or similar is required