Texas Licensed Payment Integrity Analyst

Job Summary

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

Key Responsibilities

• Review and complete internal audits and appeals based on client policies and CMS guidelines
• Utilize clinical judgment to analyze documentation for claim audits
• Attend meetings and complete additional assigned duties as necessary

Required Qualifications and Education

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