Clinical Validation Auditor (CVA) Auditor III

Responsibilities: Review medical records to validate billed DRG codes and ensure medical claims are coded accurately. Identify overpayments and provide professional explanations for clinical decisions.

Requirements: Requires a Registered Nurse (RN) license with at least 5 years of acute care experience. Preferred qualifications include certifications such as CCS, RHIA, or RHIT and experience in DRG audits.

Key skills: Clinical Validation, DRG Auditing, Medical Record Review, Coding Validation, Acute Care Nursing, Clinical Judgment, Microsoft Excel, Microsoft Word, Microsoft OneNote, PPR Readmission Reviews

Keywords: Registered Nurse, RN, DRG, CCS, RHIA, RHIT, PPR, Healthcare Analytics, Clinical Validation, Medical Coding, Acute Care, Inpatient Care, Medical Auditing