Job Details

A company is looking for a DRG Validation Auditor (Clinical & Coding).Key ResponsibilitiesAnalyze and audit inpatient claims, integrating coding principles and clinical guidelinesUtilize proprietary auditing systems to make determinations and generate audit lettersMaintain production goals and achieve accuracy and quality standards set by managementRequired QualificationsAssociate or bachelor's degree in nursing or Health Information Management (RHIA or RHIT)High school diploma or GED with 5+ years of experience in claims auditing or recovery auditingCoding/CDI certification (RHIA, RHIT, CPC, CCS, CIC, CDIP, or CCDS)5 to 7+ years of experience with ICD-9/10CM, MS-DRG, AP-DRG, and APR-DRGProficiency in Word, Access, Excel, TEAMS, and other applications