State Licensed Clinical Coding Auditor

A company is looking for a Sr. Clin Claim Review RN.

Key Responsibilities

Conduct MS-DRG and APR-DRG coding reviews to ensure accurate DRG assignment and identify overpayments

Perform clinical coding reviews using ICD-10-CM / PCS guidelines and maintain compliance with coding standards

Manage daily case review assignments with a focus on quality and provide clinical support to other areas

Required Qualifications

Unrestricted RN (registered nurse) license

CCS / CIC certification

3+ years of MS DRG / APR DRG coding experience in a hospital setting

Expert knowledge of ICD-10 Official Coding Guidelines and DRG reimbursement methodologies

In-depth understanding of ICD-10-CM and ICD-10-PCS coding structures and components