CCS Certified Nurse Auditor

Job Summary

A company is looking for a Nurse Inpatient Coding Auditor, CIC or CCS certified.

Key Responsibilities

• Audit and analyze neonatal intensive care unit (NICU) claims according to ICD-10 coding principles and clinical guidelines
• Perform clinical reviews of medical records to validate claims coding accuracy, medical necessity, and appropriateness of treatment settings
• Research reimbursement regulations for claim payment compliance and assist in developing claims audit process documentation

Required Qualifications

• Registered Nurse required
• Inpatient Coding Certification required - CCS or CIC
• 3+ years of experience with ICD-9/10CM, MS-DRG, AP-DRG, and APR-DRG payment systems
• Expert knowledge of DRG, ICD-10, CPT, and HCPCS codes
• Adherence to official coding guidelines and regulatory compliance guidelines