[Remote] Nurse Coder DRG Auditor I (US Remote)

Note: The job is a remote job and is open to candidates in USA. TREND Health Partners is a tech-enabled payment integrity company focused on improving access to healthcare through collaboration between payers and providers. The Nurse Coder DRG Auditor I is responsible for reviewing medical records to validate the accuracy of DRG assignments and medical necessity for inpatient care, applying coding and clinical principles according to industry standards. Responsibilities • Utilize coding guidelines and clinical guidelines to perform DRG validation • Validate principal diagnosis, secondary diagnoses, sequencing of diagnoses, discharge statuses and procedures utilizing the medical record • Evaluate short stay claims for medical necessity of an inpatient level of care • Apply CPT and ICD-10 guidelines • Apply policies, procedures, guidelines and regulations developed by Centers for Medicare and Medicaid Services (CMS), commercial payers, InterQual, MCG, and Trend Health Partners • Provide appeal responses for claims of the above types utilizing industry standards and company/client policies • Assist with new concept development • Assist with claim selection criteria • Assist with itemized bill review as needed • Maintain licensures, certifications and continuing education requirements • May require client communication to support findings Skills • An active RN professional license in good standing • 5 years of clinical practice • Coding certification in good standing. Examples: CCS, CPC, CIC • 2-5 years coding validation/auditing experience • Well-developed verbal and written communication skills coupled with recognizable organization • Ability to effectively prioritize tasks • Microsoft Office experience, specifically Excel • Appeals experience a plus • APR-DRG experience a plus • Client communication experience a plus • Concept development experience a plus • Claim selection experience a plus • Experience with machine learning/artificial intelligence a plus • Case Management and/or Utilization Review experience a plus • Clinical Documentation Improvement experience a plus • Itemized bill validation experience a plus • Quality Assurance experience a plus • Management experience a plus • Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) a plus • TruCode/TruBridge, 3M, WebStrat or similar experience a plus Benefits • Highly valued health insurance • A 401(k) plan with employer match • Paid parental leave • And more Company Overview • Trend Health Partners is an employee owned company that provides payment accuracy services for people. It was founded in 2018, and is headquartered in Hunt Valley, Maryland, USA, with a workforce of 201-500 employees. Its website is Apply tot his job