Clinical Validation Auditor

Focused on Coding and Clinical Chart Validation for inpatient audits, the full-time Clinical Validation Auditor will analyze claims, utilize proprietary audit tools, and maintain productivity and accuracy standards in a remote work environment. Key responsibilities Analyzes and audits inpatient claims, applying advanced ICD-10 coding expertise and clinical guidelines Utilizes proprietary auditing systems to make determinations and generate audit letters effectively Meets or exceeds productivity and accuracy standards set by the audit operations management team Required qualifications Associate or bachelor's degree in nursing or Health Information Management (RHIA or RHIT) or equivalent experience of 5+ years in claims auditing Current coding/CDI certification (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 Proficient in Microsoft Word, Access, Excel, TEAMS, and other relevant applications Expert knowledge of coding guidelines and regulatory compliance standards