[Remote] Nurse Auditor 2

Key Details • Experience Level: Mid-level (3 to 4 years) • Job Type: Full Time • Visa Sponsorship: Unknown • Industries: Healthcare Responsibilities Performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement Validates and interprets medical documentation to ensure capture of all relevant coding Applies clinical and coding experience to conduct a clinical validation review of the inpatient medical record to validate billed diagnoses Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed Follows established guidelines/procedures Requirements Associate degree Active Registered Nurse (RN) license in the state of current residence Minimum of 2 consecutive years acute inpatient hospital care experience in critical, intensive care setting within the last 5 years (not pediatrics or neonatal), e.g., ICU, CCU, PCU, med-surg/adult units, or minimum of 2 years DRG Inpatient auditing (inpatient experience excludes ER, OR, Pre-op, PACU, L&D, mother-baby, behavioral health, SNF, care manager/discharge manager, LTC, rehab, outpatient or office/clinic visits such as wound care, oncology, radiology, interventional radiology, lab, hospice, or home health) In depth knowledge and critical understanding of complex medical diagnoses including, but not limited to, Sepsis (including end-organ failure), Pneumonia, Acidosis, Renal Failure, Encephalopathy, CVA, DKA, MI, etc Advanced knowledge of MS Office (Word, Excel, etc.) Excellent writing, editing, interpersonal, planning, teamwork, and communications skills Demonstrated ability to exercise solid judgment and discretion in handling and disseminating information Ability to work independently and manage workload Customer-service focused and exhibits professionalism, flexibility, dependability, desire to learn, commitment to excellence and commitment to profession Ability to meet work at home technical requirements (e.g., minimum download speed of 25 Mbps, upload speed of 10 Mbps; wireless, wired cable or DSL connection suggested; work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information) Skills • Registered Nurse (RN) • acute inpatient hospital care • ICU • CCU • PCU • med-surg • DRG auditing • clinical validation • diagnosis coding • medical record review Apply tot his job