Nurse Coder, DRG Auditor I

🕒 April 1

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Trend Health Partners

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2018

⚕️ Healthcare Insurance

💳 Fintech

🤖 Artificial Intelligence

💰 Private Equity Round on 2023-01

Healthcare Insurance • Fintech • Artificial Intelligence

Trend Health Partners is a healthcare technology company focused on enhancing payer-provider collaboration to improve financial management in healthcare. By leveraging AI-enabled technology, Trend Health Partners offers solutions to reduce credit balances, minimize payment denials, and ensure payment accuracy, ultimately fostering better relationships among stakeholders in the healthcare ecosystem. With a commitment to neutrality and efficiency, they aim to reshape the healthcare financial landscape for the benefit of providers, payers, and patients alike.

📋 Description

• Review medical records and associated claim information to validate accuracy of DRG assignments, APC assignments and/or medical necessity for inpatient level of care • Apply coding and clinical principles based on industry standards and company/client guidelines • Utilize coding guidelines and clinical guidelines to perform DRG or APC 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

🎯 Requirements

• An active RN professional license in good standing • Clinical practice experience • Coding certification in good standing. Examples: CCS, CPC, CIC • 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

🏖️ Benefits

• Competitive salaries • Highly valued health insurance • 401(k) plan with employer match • Paid parental leave • Professional development opportunities