New York Licensed Clinical Validation Nurse

A company is looking for a DRG Clinical Validation Nurse.

Key Responsibilities :

Perform clinical validation by ensuring diagnosis codes billed by the provider are supported within the medical record

Interpret clinical guidelines / criteria and apply them to clinical reviews

Maintain and manage case reviews with a high emphasis on quality

Required Qualifications :

Minimum of two years' experience in clinical validation in a payment integrity setting required

Unrestricted Registered Nurse with active RN licensure required

CCS (Certified Coding Specialist) or CIC (Certified Inpatient Coder) certification preferred

Knowledge of ICD-10 coding

Basic knowledge of DRG validation and coding