Remote DRG Clinical Validation RN Auditor
Elevance Health
Costa Mesa, CA
- Remote job
Elevance Health is seeking a Diagnosis Related Group Clinical Validation Auditor-RN to audit inpatient medical records, ensuring clinical documentation supports DRGs billed and reimbursed. The role emphasizes ICD-10 coding expertise and DRG validation across multiple DRG types. Hybrid role with in-person trainings; California-based locations are included. Requires extensive experience in claims auditing and clinical documentation improvement, with preferred certifications in health information #J-18808-Ljbffr Elevance Health
Vacancy posted 1 day ago
Similar jobs that could be interesting for youBased on the Remote DRG Clinical Validation RN Auditor in Costa Mesa, CA vacancy
$35 - $62.5 per hour
...Clinical DRG RN Auditor $10,000 SIGN ON BONUS FOR EXTERNAL APPLICANTS Optum is a global organization... ...and Optum proprietary tools, you will validate ICD-10 diagnosis and procedure codes,... ...Ability to work independently in a remote environment and deliver exceptional...Remote jobHourly payDaily paidMinimum wageFull timeTemporary workPart timeWork experience placementWork at officeLocal areaRelocation package- UnitedHealth Group is seeking a Clinical DRG RN auditor to apply expert MS-DRG/APR-DRG coding knowledge and ICD-10 guidelines in inpatient claims audits. This remote role allows telecommuting from anywhere in the U.S. with a sign-on bonus for external applicants. Responsibilities...Remote jobRelocation package
- Elevance Health is seeking a Diagnosis Related Group Clinical Validation Auditor-RN (CDI, MS-DRG, AP-DRG and APR-DRG) to review inpatient records and ensure... ...-person training, promoting flexibility and autonomy; remote work may be supported regionally. Strong ICD-10 coding...Remote jobFull time
$86.56k - $155.81k
...Diagnosis Related Group Clinical Validation Auditor-RN (CDI, MS-DRG, AP-DRG and APR-DRG) Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach...SuggestedFull timeWork at officeLocal area- UnitedHealth Group is hiring a Clinical DRG RN auditor to apply MS-DRG/APR-DRG knowledge, ICD-10 guidelines, and AHA Coding Clinic guidance in inpatient claim audits. You will validate codes, DRG assignments, and discharge status to identify overpayments and compose rationales...Remote job
$34.23 - $61.15 per hour
About This Role As a Clinical DRG RN Auditor at UnitedHealth Group, you will leverage your expertise in MS-DRG and APR-DRG coding methodologies to audit inpatient claims, ensuring accuracy and identifying overpayments. This role is ideal for those with strong analytical...Hourly payFull timeTemporary workRelocation packageDay shift- Optum, a part of UnitedHealth Group, seeks a Clinical DRG RN auditor to review MS-DRG and APR-DRG coding for inpatient claims and identify overpayments... ...and maintaining high-quality audit outputs. You will work remotely from anywhere in the U.S. and use proprietary tools to...Remote jobRelocation package
$85k - $95k
...accuracy, accountability, and clinical excellence to healthcare. As... ...integrity solutions including DRG Validation, Cost Outlier and Readmission... ...Registered Nurse with active RN licensure required CCS (... ...applications at the same time Remote Work Requirements High...Remote workFull timeMonday to FridayMedReview LLC
United States5 days ago$31.25 - $38.46 per hour
Overview This auditing role will focus on Coding & Clinical Chart Validation for our Inpatient audits. The ideal candidate for this position needs... ...disciplines from a coding and billing perspective: Inpatient DRG/APR-DRG and/or episode of care. This position is responsible...Hourly payWork at office$70.8k - $123.8k
...Clinical Nurse Auditor CGI is one of the world's largest independent... ...medical necessity, validate clinical services, and... .... This position is remote within the United States... ...Clinical Validation and DRG validation activities... ...Registered Nurse (RN) license in your state...Remote workWork at office- ...documentation in the Medical Record.Seeking RN candidates with a HCS-D - Home Care... ...COS-C Certificate for OASIS Specialist-Clinical. Remote position in New York.Job Responsibility... ...clinical expertise to identify and validate DRG code assignment.2. Full review of CDI suggested...Remote workHourly payFull time
FlexStaff Careers
Garden City, NY18 hours ago $55.1k - $99k
...Clinical Coding Auditor & Trainer This is a remote position. Compensation: $55,100.00 - $99,000.00 per... ...travel to New York twice a year RN, PA, MD, APRN, DO, or MBBS license Valid/Current CPC or CIC... ...equivalent experience ~4+ years of DRG and/or Medical Record Audit...Remote workInteletech Global Inc.
United States16 hours ago- ...Focusing on Coding & Clinical Chart Validation, the full-time Clinical Coding Auditor will analyze and audit inpatient claims, ensuring coding accuracy and appropriateness... ...5 to 7+ years of experience with ICD-9/10CM, MS-DRG, AP-DRG, and APR-DRG Certification in coding/CDI...Remote workFull time
Virtual Vocations Inc
United States3 days ago - Molina Healthcare is seeking an RN with a US license in good standing to join the Medicaid Team as a Clinical Auditor. The role may offer remote work flexibility, but the candidate must reside in Michigan and operate within Michigan-based guidelines. The incumbent will...Remote job
$85k - $95k
RCM Healthcare Services is seeking a DRG Coding Reviewer to support inpatient coding validation and payment integrity initiatives. This remote, full-time role offers a salary of $85,... ...and DRG assignments, perform coding and clinical validation reviews, and collaborate...Remote jobFull time- Optum Insight is seeking a Clinical Claim Review RN to perform compliance reviews of medical and administrative... ..., and collaboration with a team of auditors to document findings and input data... ...is full-time (40 hours/week) with remote work options in Massachusetts and potential...Remote jobFull timeLocal area
$90k - $115k
A healthcare intelligence company is seeking a DRG Reviewer to conduct payment validation reviews. The ideal candidate will possess a nursing degree or... ...Responsibilities include auditing medical records, providing clinical support, and ensuring compliance with regulations. The...Remote jobFlexible hours$60.2k - $107.4k
Optum is seeking an Utilization Management & Clinical Validation RN who will review and extract case details from patient records and craft defensible appeal letters in line with process guidance. You will use encoders, ICD-9/10, CM/PCS, CPT, HCPCS and supporting literature...Remote job- Optum is seeking a Utilization Management & Clinical Validation RN to review medical records, extract pertinent details, and craft defensible appeal letters. The role involves coding knowledge, literature references, and HIPAA compliance, with a telecommute option from...Remote job
$55.1k - $99k
Job Overview Clinical Coding Auditor & Trainer - Remote, NY, US. The position is primarily remote... ...Required Qualifications RN, PA, MD, APRN, DO, or MBBS... ...experience 4+ years of DRG and/or Medical Record Audit... ...experience in a hospital setting Valid/Current CPC or CIC...Remote workPermanent employmentFull time- Optum, a UnitedHealth Group company, is seeking an Utilization Management and Clinical Validation RN to review medical records and craft defensible appeal letters. You will work with evidence-based medical literature and coding guidelines, while supporting telecommuting...Remote job
- UnitedHealth Group's Optum is seeking an experienced RN for Utilization Management & Clinical Validation. You will review patient records, extract pertinent... ...evidence-based literature and coding guidelines. This remote role supports telecommuting from anywhere in the U.S...Remote jobFlexible hours
- ...people live healthier lives. The Utilization Management and Clinical Validation RN will review patient medical records, extract pertinent details... ...per process instructions and guidelines. This role is remote from anywhere in the U.S. with an unrestricted RN license, associates...Remote job
- ...years. Position Summary The DRG Auditor is responsible for reviewing... ...inpatient claims to identify and validate missed reimbursement... ...medical record documentation, clinical coding guidelines, and DRG reimbursement... ...is primarily office-based or remote, depending on company policy,...Remote jobFlexible hours
$45.67 per hour
Overview This auditing role will focus on Coding & Clinical Chart Validation for our Outpatient and Specialty audits. The ideal candidate for this... ...activities with Outpatient (APC, PNPP), Pharmacy and/or Inpatient DRG claims. Draws on advanced coding expertise and industry...Hourly payContract workWork at office- CERIS, a division of CorVel, seeks a DRG Clinical Auditor to perform DRG validation reviews, determine correct coding, and document findings. The role requires ICD-10-CM/PCS proficiency, clinical knowledge, and familiarity with medical necessity rules. The position emphasizes...
$60.2k - $107.4k
...Utilization Management & Clinical Validation Rn Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the...Remote jobMinimum wageFull timeWork experience placementLocal area$69.3k - $78k
...Medical Review Nurse II - Clinical Validation At Performant, we’re... ...experienced medical auditors and coders performing... ...Payers. You will work remotely in a fast paced and dynamic... ...Active unrestricted RN license in good... ...coding, HCPCS/CPT coding, DRG and medical billing experience...Remote workFor contractorsWork at officeWork from homeHome officeShift work$90k - $110k
...DRG Revenue Integrity Auditor Remote CareNational is looking for an experienced DRG Revenue Integrity Auditor ! Ideal candidates will have... ...Maintain quality of reviews and make sure the true clinical picture is captured, along with ensuring chart review...Remote workImmediate startWork from homeCareNational
Plano, TX3 days ago$92.4k - $133.67k
...in accordance with P&P’s. 4 Assists the clinical team in responding to audited providers... ...Educates Providers, SCAN staff and Compliance Auditors on regulatory requirements and... ...$133,671 annually Work Mode: Partially Remote An annual employee bonus program Robust...Remote workContract workFor contractorsLocal areaHome office
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Remote DRG Clinical Validation RN Auditor. Be the first to apply!
Related searches
- fema rn Costa Mesa, CA
- icu rn Costa Mesa, CA
- school rn Costa Mesa, CA
- labor and delivery registered nurse rn Costa Mesa, CA
- part time rn Costa Mesa, CA
- rn Costa Mesa, CA
- rn quality Costa Mesa, CA
- registered nurse rn part time Costa Mesa, CA
- outpatient registered nurse Costa Mesa, CA
- radiology - rn Costa Mesa, CA