Remote Nurse Inpatient Coding Auditor (CIC/CCS)

ProgenyHealth LLC; United States; Remote; USD 85,000 - 125,000; Full time

Benefits offered by this job

Paid Time Off

401K with company match

Short- and Long-Term Disability

Group Life Insurance

Business Casual work environment

Paid Parental Leave

Medical, dental, vision benefits

Tuition reimbursement

Professional development opportunities

Job summary

ProgenyHealth LLC is hiring a Nurse Inpatient Coding Auditor for a fully remote role in the United States. The Clinical RN Chart Reviewer will evaluate NICU claims for coding accuracy, medical necessity, and appropriate settings, reporting to the Payment Assurance Manager.

Required are RN licensure, 2+ years inpatient claims experience, and CCS or CIC certification (or plan to obtain within 6 months). ProgenyHealth offers comprehensive benefits and salary commensurate with experience.

Qualifications

• RN required and licensed to practice.
• 2+ years inpatient claims experience, NICU/maternity preferred.
• Inpatient coding certification required (CCS or CIC) or plan to obtain within 6 months.

Responsibilities

• Audit NICU claims per ICD-10 coding principles and clinical guidelines.
• Analyze claims data to ensure codes justify services.
• Ensure compliance with coding standards, guidelines, and regulatory requirements.
• Perform clinical reviews of medical records to validate coding accuracy and medical necessity.
• Utilize clinical review tools and EMR systems.
• Research reimbursement regulations to support audit findings.
• Develop claims audit process documentation and SOPs.
• Identify discrepancies in provider billing and recommend adjustments.

Skills

Registered Nurse

Inpatient coding

NICU experience

Excellent communication

Interpersonal skills

Education

RN license

Tools

MS-DRG knowledge

ICD-9/10CM expertise

EMR systems

Job description

ProgenyHealth LLC is hiring a Nurse Inpatient Coding Auditor for a fully remote role in the United States. The Clinical RN Chart Reviewer will evaluate NICU claims for coding accuracy, medical necessity, and appropriate settings, reporting to the Payment Assurance Manager.

Required are RN licensure, 2+ years inpatient claims experience, and CCS or CIC certification (or plan to obtain within 6 months). ProgenyHealth offers comprehensive benefits and salary commensurate with experience.