Job Description

Position Title: DRG Clinical Validation Auditor

USRN with at least 2 years of bedside experience

Candidates must have 1-2 years of hospital coding experience.

One or more of the following certifications:

  • Certified Documentation Improvement Practitioner (CDIP- AHIMA)
  • Certified Professional Coder (CPC)
  • Inpatient Coding Credential such as CCS (AHIMA)-IP/OP
  • Inpatient Coding Credential such as CIC (AAPC)
  • RHIT or RHIA (preferred Certification)
  • Certified Clinical Documentation Specialist (CCDS)

Responsible for auditing inpatient medical records to ensure clinical documentation supports the conditions and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims.

Primary duties may include but are not limited to:

  • Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines, and objectivity in the perfo...

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