Clinical Review Auditor

CorVel; United States; Remote; USD 70,000 - 105,000; Full time

Job summary

Join a leading healthcare company offering a remote DRG Auditor role, where you'll perform audits and ensure accurate coding. This position offers a competitive salary and comprehensive benefits while promoting career advancement. Enjoy a flexible work environment and be part of a recognized Great Place to Work.

Benefits

Comprehensive benefits package including medical, dental, and vision coverage

Opportunity for career advancement

Qualifications

• Minimum of 1 year of DRG auditing experience in a hospital or health plan.
• Extensive hands-on experience with ICD-10-CM and PCS coding.
• Proficient in Medicare and CMS guidelines.

Responsibilities

• Perform DRG validation reviews of medical records.
• Communicate findings to relevant stakeholders.
• Conduct audits to enhance reimbursement.

Skills

Attention to detail

Effective communication

Education

National Coding Certification through AHIMA or AAPC

Tools

Microsoft Office Suite

Job description

Employer Industry: Healthcare Services

Why consider this job opportunity:
- Salary up to $104,841
- Comprehensive benefits package including medical, dental, and vision coverage
- Opportunity for career advancement and growth within a stable and supportive company culture
- Work remotely, offering flexibility in your work environment
- Join a certified Great Place to Work Company with a commitment to transparency and accuracy in healthcare payments

What to Expect (Job Responsibilities):
- Perform DRG validation reviews of medical records to ensure accurate coding
- Review physician notes to support assigned DRGs and check for missing documentation
- Conduct audits to enhance reimbursement and identify potential savings
- Communicate findings clearly and accurately to relevant stakeholders
- Work independently while demonstrating initiative in a fast-paced production environment

What is Required (Qualifications):
- Minimum of 1 year of recent DRG auditing experience in a hospital or health plan
- National Coding Certification required through AHIMA (preferred) or AAPC
- Extensive hands-on experience with ICD-10-CM and PCS coding
- Proficient in Medicare and CMS guidelines
- Strong attention to detail and effective communication skills

How to Stand Out (Preferred Qualifications):
- RN license (preferred but not required)
- Proficient in both MS and APR DRG methodology
- Knowledge of current Official Coding Guidelines and Coding Clinic citations
- Ability to think critically and solve problems effectively
- Familiarity with Microsoft Office Suite

#HealthcareServices #RemoteWork #CareerOpportunity #CompetitivePay #HealthcareAuditing

"We prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately.
We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer."