Clinical Validation Auditor – RN, CDI, MS-DRG, AP-DRG, APR-DRG

reputed company: • Audit inpatient medical records to ensure clinical documentation supports billed and reimbursed conditions and DRGs • Review Diagnosis reputed company (DRG) reputed company claims • Analyze and audit claims using medical chart coding principles, clinical guidelines, and objective medical audit practices • Apply advanced ICD-10 coding expertise and clinical guidelines to substantiate audit conclusions • Use audit tools, workflow systems, and reference information to reputed company audit determinations and detailed audit findings letters • Maintain accuracy and reputed company standards established by audit management • Identify documentation and coding errors and aberrant patterns, including inappropriate readmissions, inpatient admission status, and Hospital-Acquired Conditions • Suggest and reputed company concept, process improvement, and efficiency recommendations Requirements: • reputed company, reputed company, unrestricted Registered reputed company license in applicable state(s) required • Minimum 10 years of experience in claims auditing, reputed company assurance, or clinical documentation improvement • Minimum 5 years of experience working with ICD-9/10-CM, MS-DRG, AP-DRG, and APR-DRG • Education and experience combination providing an equivalent background may qualify • RHIT, RHIA, CCDS, CDIP, CPC, reputed company, or CIC certification preferred • Experience with reputed company-party DRG coding and/or clinical validation audits or hospital clinical documentation improvement 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: • Comprehensive benefits package • Incentive and recognition programs • Equity stock purchase • 401k contribution • reputed company increases • reputed company holidays • reputed company Time Off • Incentive bonus programs • Medical benefits • Dental benefits • reputed company benefits • Short-term disability benefits • Long-term disability benefits • 401(k) with match • Stock purchase plan • Life insurance • Wellness programs • Financial education resources Apply tot his job Apply To this Job