DRG Clinical (RN) Validation Auditor
Elevance Health(1 month ago)
RemoteFull TimeSenior$90,000 - $135,702Clinical
Apply NowAbout this role
The DRG Clinical (RN) Validation Auditor at Elevance Health reviews inpatient medical records to ensure clinical documentation substantiates billed Diagnosis Related Groups (DRGs) and reimbursements. The role focuses on validation of DRG paid claims and operates primarily in a virtual capacity with required in-person training. It supports the organization’s coding, compliance, and documentation integrity efforts within the clinical operations function.
Required Skills
- DRG Auditing
- ICD-10
- Clinical Documentation
- Medical Coding
- Chart Review
- Audit Tools
- Quality Assurance
- Documentation Improvement
- Clinical Guidelines
- Process Improvement
Qualifications
- Registered Nurse License
- CCDS
- CDIP
- CPC
- CCS
- CIC
About Elevance Health
elevancehealth.comElevance Health, formerly Anthem, Inc., serves people across their entire health journey taking an integrated whole-health approach.
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