VDart BPM
We extend assistance in improving business processes that empowers the organization's overall growth. Our ultimate goal is to improve corporate performance through a systematic approach.
Title: Clinical Nurse Specialist Mode : Remote Pay Rate : $37/hr on W2 REQUIRED: ACTIVE RN LICENSE (multi-state preferred)
Active RN license (multi-state preferred) OR Certified Coding Specialist (CCS), Certified Inpatient Coder (CIC), CPC, CSS, RHIT, or equivalent credential. Minimum 3ā5 years of experience in clinical coding and DRG validation. Strong knowledge of CMS guidelines, payer policies, and therapy benefit structures. Experience with reconsiderations, appeals, and code editing (CPC experience preferred). Medicaid experience strongly preferred. Ability to teach systems and code editor tools; prior coding experience required. Preferred Skills: Familiarity with state-specific coding policies and written guidelines. Knowledge of all service types and payer structures. Strong analytical and organizational skills
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Perform clinical coding and DRG validation for various service types. Review claims for accuracy and severity of stay based on appropriate diagnosis codes. Apply CMS guidelines, state policies, and payer requirements in coding processes. Support appeals and reconsiderations, including Medicaid-related cases. Collaborate with vendors and internal teams on coding and editing systems. Ensure compliance with coding certifications and payer policies.
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Basic
Telehealth
$34
Resume Template Package
ATS optimized design for nurses
Matching Cover Letter
Matching Reference Page
Resume Tips and Tricks
ADVANCED
Telehealth
$79
Everything from Starter Pack
Resume Optimization Guide
7 Nurse Resume Examples
20+ Professional Summary Examples
How to Structure Unique Career Experiences
BEST VALUE
Telehealth
$149
Everything from Starter Pack
Everything from Pro Toolkit
Career Accelerator Success Guide
Proven method for landing your dream role
Lifetime Premium Job Board Access
Application Tracker
1:1 Expert Support
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