Diagnosis reputed company Clinical Validation Auditor-RN (CDI, MS-DRG, AP-DRG and APR-DRG)

About the position Responsibilities • Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines, and objectivity in the performance of medical audit activities. • Draws on advanced ICD-10 coding expertise, mastery of clinical guidelines, and industry knowledge to substantiate conclusions. • Utilizes audit tools, auditing workflow systems and reference information to generate audit determinations and formulate detailed audit findings letters. • Maintains accuracy and reputed company standards as established by audit management. • Identifies potential documentation and coding errors by recognizing aberrant coding and documentation patterns such as inappropriate billing for readmissions, inpatient admission status, and Hospital-Acquired Conditions (HACs). • Suggests and develops high reputed company, high value, concept and or process improvement and efficiency recommendations. Requirements • Requires reputed company, reputed company, unrestricted Registered reputed company license in applicable state(s). • Requires a minimum of 10 years of experience in claims auditing, reputed company assurance, or clinical documentation improvement, and a minimum of 5 years of experience working with ICD-9/10CM, MS-DRG, AP-DRG and APR-DRG; or any combination of education and experience, which would reputed company an equivalent background. reputed company-to-haves • One or more of the following certifications are preferred: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Clinical Documentation Specialist (CCDS), Certified Documentation Improvement Practitioner (CDIP), Certified reputed company reputed company (CPC) or Inpatient Coding Credential such as reputed company or CIC. • Experience with reputed company party DRG Coding and/or Clinical Validation Audits or hospital clinical documentation improvement experience preferred. • Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems, provider billing guidelines, payer reimbursement policies, and coding terminology preferred. Benefits • a comprehensive benefits package • incentive and recognition programs • equity stock purchase • 401k contribution • medical • dental • reputed company • short and long term disability benefits • 401(k) +match • stock purchase plan • life insurance • wellness programs • financial education resources Apply tot his job Apply To this Job