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Registered Nurse - Diagnosis Related Group (DRG) Coding Auditor Principal - Carelon Payment Integrity. Registered Nurse - Diagnosis Related Group Coding Auditor Principal - Carelon Payment Integrity. Operates largely independently and autonomously with little oversight due to extremely high-quality

Audits and reviews Medicare/non-Medicare charts to ensure that proper standards are maintained in compliance with Federal and State regulations. Operates under general guidance and work assignments are varied and require interpretation and independent decisions on course of action. Performs related

Seeking RN candidates with a HCS-D - Home Care Coding Specialist-Diagnosis, COS-C Certificate for OASIS Specialist-Clinical. Full review of CDI suggested code changes 3. Reviews potential reassignments; demonstrates accurate and timely review of all reassignments.

For RN Quality Reviewer only: * Provides clinical support in the Grievance and Appeals process.

Validates Acute Inpatient coded charts to ensure the diagnostic information leading to the assignment can be substantiated by the documentation in the Medical Record. ICD-10 medical coding experience, highly preferred.