CDI DRG Auditor Nurse

Start Date: 06/02/2025 Positions available: 4 Training hours must be Eastern time between 8AM – 4PM. Work hours: 8 hours straight between 6 AM and 6 PM EST. Job Type: W2 contract to hire/ temp to perm (conversion to full time after 6 months) Job Summary: We are actively hiring experienced Clinical and Coding Auditors to support inpatient medical claims audits with a focus on DRG/APR-DRG validation and clinical chart review. This role requires a unique blend of clinical nursing and coding expertise, emphasizing accuracy, compliance, and quality in audit execution. Training begins May 5th. Schedule: Training Schedule: Monday–Friday, 8:00 AM–4:00 PM EST Regular Work Hours: Flexible start time between 8:00 AM–10:30 AM EST (Must complete a full shift ending no later than 6:00 PM EST)

Audit Inpatient Claims: Review clinical documentation for accurate coding, appropriateness of treatment setting, and correct DRG/APR-DRG assignment. Utilize Coding & Audit Tools: Work with systems to perform high-volume, high-accuracy audits and generate audit letters. Analyze Data & Apply Standards: Leverage knowledge of ICD-10, coding guidelines, and industry standards for auditing and documentation. Ensure Productivity & Accuracy: Consistently meet or exceed internal productivity and quality benchmarks. Identify Opportunities for Improvement: Propose new claim types, recovery opportunities, or process enhancements.