DRG Clinical Validation Nurse

Position Summary

At MedReview, our mission is to bring accuracy, accountability, and clinical excellence to healthcare. As such, we are a leading authority in payment integrity solutions, including DRG Validation and Readmission review. We are seeking a clinically experienced, registered nurses with utilization management, inpatient coding, and/or clinical validation experience to work within our clinical validation department.

This is a fulltime position (37.5 hours per week) Monday – Friday. You’ll enjoy the flexibility to telecommute from anywhere within the United States. Training will be conducted virtually from your home and all necessary equipment will be provided.

If you are interested in this role with MedReview, please let us know. Here is what we are searching for:

Qualifications

• Minimum of two years’ experience in inpatient coding, utilization management, and/or clinical validation
• Knowledge of health insurance business, industry terminology, and regulatory guidelines
• Minimum of 3 years clinical experience in a hospital setting with experience including but not limited to reading history and physical examination reports, interpreting laboratory and ancillary test results, and discharge summary reports.
• Active, unrestricted RN license
• CCS or CIC certification is highly desired
• Ability to use common computer applications, such as Word
• Understanding of anatomy, physiology, and diagnostic and surgical procedures
• Working knowledge of clinical criteria documentation requirements used to successfully substantiate code assignments
• The ability to accurately interpret a medical record
• The ability to work in an environment with productivity expectations
  
  

Responsibilities

• Perform clinical record review, utilizing clinical expertise, judgement, guidelines, and policies to ensure the accuracy of medical coding
• Write clear, accurate and concise rationales in support of findings
  
  

Remote Work Requirements

• High speed internet (100 Mbps per person recommended) with secured WIFI.
• A dedicated workspace with minimal interruptions to protect PHI and HIPAA information
• Must be able to sit and use a computer keyboard for extended periods of time
  
  

Benefits and perks include:

• Healthcare that fits your needs - We offer excellent medical, dental, and vision plan options that provide coverage to employees and dependents
• 401(k) with Employer Match - Join the team and we will invest in your future
• Generous Paid Time Off - Accrued PTO starting day one, plus additional days off when you’re not feeling well, to observe holidays
• Wellness - We care about your well-being. From Commuter Benefits to FSAs we’ve got you covered
• Learning & Development - Through continued education/mentorship on the job and our investment in LinkedIn Learning, we’re focused on your growth as a working professional
  
  

Salary: $85k-95k

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