Clinical Validation Auditor

A company is looking for an Auditor Clinical Validation DRG. Key Responsibilities Analyzes and audits inpatient claims, integrating medical chart coding principles and clinical guidelines Utilizes proprietary auditing systems to make audit determinations and generate audit letters Maintains productivity and accuracy standards set by management while identifying new claim types for potential recoveries Required Qualifications Associate or bachelor's degree in nursing or Health Information Management (RHIA or RHIT), or equivalent experience with a high school diploma / GED Certification in coding / CDI (RHIA, RHIT, CPC, CCS, CIC, CDIP, or CCDS) required 5 to 7+ years of experience with ICD-9 / 10CM, MS-DRG, AP-DRG, and APR-DRG Expert knowledge of coding guidelines and compliance regulations Proficiency in Microsoft Office applications