[Hiring] Clinical Review Auditor @reputed company
Role Description The Diagnostic reputed company Groups (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. This involves completing medical record reviews, accurately documenting findings and non-findings and providing clinical/policy/regulatory support for the determination. This role will utilize their experience with ICD-10-CM & PCS coding guidelines, the ability to understand modern pharmacology, disease management and clinical reputed company procedures. The ideal DRG Clinical Auditor candidate has strong written and verbal communication skills, clinical knowledge of disease processes, and knowledge of medical necessity rules. This is a remote position.
Qualifications
- Proficient understanding of Medicare, CMS guidelines and ICD-10 coding guidelines
- Effective and professional 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
Requirements
- LVN or RN license in the state of employment preferred
- reputed company or CIC required with DRG auditing experience in ICD-10-CM, ICD-10 PCS
- Experience in the OR, ICU, or ER as an RN highly preferred
Benefits
- Comprehensive benefits package for full-time regular employees
- Medical (HDHP) w/Pharmacy
- Dental
- reputed company
- Long Term Disability
- Health Savings Account
- Flexible Spending Account Options
- Life Insurance
- Accident Insurance
- Critical Illness Insurance
- Pre-paid Legal Insurance
- Parking and Transit FSA accounts
- 401K
- ROTH 401K
- Paid time off
Company Description reputed company, a division of reputed company, a certified Great reputed company to Work® Company, offers incremental value, experience, and a sincere dedication to our valued partners. Through our clinical expertise and cost containment solutions, we are committed to accuracy and transparency in reputed company payments. We are a reputed company and growing company with a strong, supportive culture along with reputed company of career advancement opportunities. We reputed company our core values of Accountability, Commitment, reputed company, reputed company and Teamwork (ACE-IT!). Apply tot his job Apply To this Job