Clinical DRG Auditor (Remote Nurse) Full Time

Responsibilities

• Perform audits of medical record documentation to determine the accuracy of principal and secondary diagnosis and procedure codes.
• Adhere to official coding guidelines, coding clinics, and regulatory mandates.
• Utilize advanced ICD-10 coding expertise and clinical knowledge to substantiate conclusions.
• Use HMS proprietary auditing systems proficiently to document audit determinations and rationale.
• Apply clinical review judgment to make coding validation determinations including sequencing ICD-10-CM and ICD-10-PCS codes.
• Achieve productivity and quality performance standards established by management.
• Assist with training new Coders or Clinical DRG Auditors, including monitoring, mentoring, feedback, and education.
• Maintain current knowledge of coding guidelines and complete required CEUs for RN license and coding certification.
• Attend training and meetings to enhance skills and knowledge of clinical policies, procedures, rules, and regulations.

Requirements

• Active and unrestricted RN license required.
• One of the following Coding Certifications within 1 year of hire required: RHIA, RHIT, CCS, CIC, CCDS, or CPC.
• 5+ years of clinical experience in an inpatient hospital setting required.
• 3+ years of MS DRG/APR DRG coding or auditing experience with expert knowledge of ICD-10 Official Coding Guidelines and DRG reimbursement methodologies.
• Expert knowledge of ICD-10-CM and ICD-10-PCS coding methodologies, code sequencing, and discharge disposition.
• Demonstrated ability to apply clinical review judgment and proficiency in computer skills (Microsoft Windows, Outlook, Excel, Word, PowerPoint, Internet browsers, and virtual meeting tools).

Benefits

• Remote Work: Work from home with a private, distraction-free area.
• Compensation: $30.00 – $42.00 per hour, varying by factors like geographic region and experience.
• Health Benefits: Comprehensive health benefits available from the first day of employment.
• Vacation Policy: Generous, flexible vacation policy.
• 401(k): Employer match available.
• Educational Assistance: Support for further education.
• Development: Access to leadership and technical development academies.
• Career Growth: Clear path for advancement with training and leadership opportunities.
• Flexible Work: Opportunities to grow your career with flexibility and a focus on continuous learning.