DRG Quality Advisor Nurse

This is a fully remote position, open to applicants in Missouri.

📋 Description

• Conduct quality assurance evaluations on the final reviews of intricate clinical claims.

• Execute DRG validation assessments of medical record documentation.

• Analyze and review claim data alongside medical record documentation.

• Utilize clinical review judgment and coding expertise for clinical assessments.

• Clearly document audit findings and review decisions.

⛳️ Requirements

• An associate's degree is necessary; a bachelor's degree is preferred.

• Active, unrestricted RN licensure in the United States is mandatory.

• One of the following Coding Certifications is required: RHIA, RHIT, CCS, CIC, CCDS, or CPC.

• A minimum of 5 years of clinical experience in an inpatient hospital environment is required.

• At least 3 years of experience in MS-DRG/APR-DRG coding or auditing.

• In-depth knowledge of ICD-10-CM coding.

• In-depth knowledge of ICD-10-PCS coding methodologies.

• Proficient in Microsoft Windows, Outlook, Excel, Word, PowerPoint, and virtual meeting platforms.

🏝️ Benefits

• Generous and flexible vacation policy.

• 401(k) employer matching.

• Comprehensive health benefits.

• Educational assistance.

• Leadership and technical development academies.