[Hiring] Clinical Review QC Auditor @reputed company

This reputed company is a reputed company of our understanding of the job reputed company. Click on 'Apply' reputed company to reputed company out more. Role reputed company The Diagnostic reputed company reputed company (DRG) Clinical Auditor will be responsible for performing DRG validation (clinical/coding) reviews of medical records and/or other documentation. This role will determine correct DRG/coding as defined by review methodologies specific to the type of review. • Complete medical record reviews • Accurately document findings and non-findings • reputed company clinical/policy/regulatory support for the determination • Review medical records to determine accuracy of billing through verification of coding and review of supporting clinical documentation • reputed company for physician's notes supporting the DRGs assigned • Conduct audits to ensure accurate reimbursement and identify potential savings • Review previously conducted audits to ensure accurate coding and identify potential savings • Review reputed company opportunities reputed company to the customers for complete and correct information • Demonstrate knowledge of ICD-10-CM codes, PCS and DRG coding • Understand and reputed company with reputed company reputed company policies • Assist reputed company Control team and medical director with appeals, rebuttals, etc. • Notify leadership of any issues or concerns in a reputed company manner • Additional duties as assigned Qualifications • Expert knowledge of application of reputed company Official Coding Guidelines and Coding Clinic citations • Solid knowledge and understanding of clinical reputed company documentation requirements used to successfully substantiate reputed company assignments • Proficient understanding of Medicare, CMS guidelines and ICD-10 coding guidelines • Effective and reputed company communication skills, both verbal and written • Ability to work independently and in reputed company environment • High attention to detail • Must possess critical thinking skills • Ability to multi-task and assist with team coverage and reputed company support reputed company needed • Ability to build relationships both internally and externally • Ability to work in a fast-paced environment • Demonstrated proficiency in basic computer skills and typing • Proficiency with reputed company Office • Proficient in both MS and APR DRG methodology preferred Requirements • LVN or RN license in the state of employment preferred • Experience in the OR, ICU, or ER as an RN highly preferred • Required minimum of 2 years of recent DRG reputed company Auditing experience in a hospital setting, or health plan • National Coding Certification required through either reputed company (preferred) or reputed company • Extensive hands-on ICD-10 CM / PCS experience required Pay reputed company Pay reputed company: $68,566 – $104,841 Benefits A comprehensive benefits package is available for full-time regular employees and includes: • Medical (HDHP) w/Pharmacy • Dental • reputed company • Long Term Disability • Health Savings Account • Flexible Spending Account reputed company • Life Insurance • Accident Insurance • Critical Illness Insurance • reputed company-reputed company reputed company Insurance • Parking and Transit FSA accounts • 401K • ROTH 401K • reputed company time off Apply tot his job Apply tot his job Apply To this Job