Clinical Auditor DRG Certification

Job Summary

A company is looking for an Auditor Clinical Validation DRG.

Key Responsibilities

• Analyze and audit inpatient claims, integrating coding principles and clinical guidelines
• Utilize proprietary auditing systems to make determinations and generate audit documentation
• Meet productivity and accuracy standards while identifying potential new claim types for recovery

Required Qualifications

• Associate or bachelor's degree in nursing or Health Information Management (RHIA or RHIT)
• Certification in coding/CDI such as RHIA, RHIT, CPC, CCS, CIC, CDIP, or CCDS
• 5 to 7+ years of experience with ICD-9/10CM, MS-DRG, AP-DRG, and APR-DRG
• Expert knowledge of official coding guidelines and compliance regulations
• Proficiency in Microsoft Office applications