[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 findingsSkills• 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 plusBenefits• Highly valued health insurance• A 401(k) plan with employer match• Paid parental leave• And moreCompany 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