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Clinical Validation Auditor, Auditor III

AuditorAuditorFull TimeRemoteTeam 10,001+H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

37 days ago

Salary

$70K - $80K / year

Associate Degree5 yrs expEnglish

Job Description

• Review inpatient medical records to verify that the DRG code makes sense based on the documentation • Apply clinical and coding knowledge to spot inaccuracies and identify potential overpayments • Document your findings in clear, professional language that explains the rationale behind your review • Use industry tools like 3M or Webstrat to support your decisions (training provided) • Work independently while meeting productivity and quality goals • Stay up to date with clinical guidelines, DRG rules, and industry trends

Job Requirements

  • Registered Nurse (RN) with an active license
  • 5+ years of acute care experience (hospital setting preferred)
  • Experience in DRG audits or coding validation is a big plus!
  • Bonus points if you have certifications like CCS, RHIA, or RHIT
  • Knowledge of readmission reviews (PPR) is also a plus

Benefits

  • Remote work
  • Opportunities for professional growth

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