TREND Health Partners is a tech-enabled payment integrity company. Our mission is to facilitate collaboration between payers and providers for mutual benefit and waste reduction, ultimately improving access to healthcare. We achieve this by aligning the common goals of payers and providers and fostering collaboration through a shared technology platform and seamless workflows.
Joining TREND Health Partners means becoming part of a dynamic, growing organization that promotes a collaborative and innovative work environment. Our comprehensive compensation package includes competitive salaries, highly valued health insurance, a 401(k) plan with employer match, paid parental leave, and more.
The Nurse Coder DRG Auditor III’s primary responsibility is to operate as a Subject Matter Expert.
Independently audit outpatient and inpatient claims applying coding guidelines while reviewing supporting medical documentation, completing appeal responses and communicating findings;
Independently validate and perform quality checks for other team members;
Execute strategic decision making authority, and support management with enterprise level recommendations.
Independently audit outpatient and inpatient claims applying coding guidelines while reviewing supporting medical documentation, completing appeal responses and communicating findings;
Independently validate and perform quality checks for other team members;
Execute strategic decision making authority, and support management with enterprise level recommendations.
TREND Health Partners is a tech-enabled payment integrity company. Our mission is to facilitate collaboration between payers and providers for mutual benefit and waste reduction, ultimately improving access to healthcare. We achieve this by aligning the common goals of payers and providers and fostering collaboration through a shared technology platform and seamless workflows.
Joining TREND Health Partners means becoming part of a dynamic, growing organization that promotes a collaborative and innovative work environment. Our comprehensive compensation package includes competitive salaries, highly valued health insurance, a 401(k) plan with employer match, paid parental leave, and more.
The Nurse Coder DRG Auditor III’s primary responsibility is to operate as a Subject Matter Expert.
Independently audit outpatient and inpatient claims applying coding guidelines while reviewing supporting medical documentation, completing appeal responses and communicating findings;
Independently validate and perform quality checks for other team members;
Execute strategic decision making authority, and support management with enterprise level recommendations.
Independently audit outpatient and inpatient claims applying coding guidelines while reviewing supporting medical documentation, completing appeal responses and communicating findings;
Independently validate and perform quality checks for other team members;
Execute strategic decision making authority, and support management with enterprise level recommendations.
TREND Health Partners is a tech-enabled payment integrity company. Our mission is to facilitate collaboration between payers and providers for mutual benefit and waste reduction, ultimately improving access to healthcare. We achieve this by aligning the common goals of payers and providers and fostering collaboration through a shared technology platform and seamless workflows. Joining TREND Health Partners means becoming part of a dynamic, growing organization that promotes a collaborative and innovative work environment. Our comprehensive compensation package includes competitive salaries, highly valued health insurance, a 401(k) plan with employer match, paid parental leave, and more. The Nurse Coder DRG Auditor III’s primary responsibility is to operate as a Subject Matter Expert. Independently audit outpatient and inpatient claims applying coding guidelines while reviewing supporting medical documentation, completing appeal responses and communicating findings; Independently validate and perform quality checks for other team members; Execute strategic decision making authority, and support management with enterprise level recommendations.
Role and Responsibilities
Qualifications
Preferred Skills
Mental and Physical Demands
Related duties as assigned
Active RN license, clinical practice and coding audit experience, coding certification such as CCS or CIC, strong communication and organization, task prioritization, and Microsoft Office Excel experience.
Key Responsibilities
- auditing claims
- validating diagnoses
- performing quality checks
Skills & Tools
Microsoft Office, Microsoft Excel, Centers for Medicare and Medicaid Services (CMS), InterQual, MCG, CPT, ICD-10, TruCode/TruBridge, 3M, WebStrat, machine learning, artificial intelligence
Job Details
- Category: Healthcare Services - Nursing
- Seniority: Senior Level
- Commitment: Full Time
- Workplace: Remote — United States
- Salary: USD 97,000 – 117,000 / year
- Languages: English
Benefits
- 401k matching
- Retirement plan
- Generous parental leave
About TREND Health Partners
A technology-enabled payment integrity company that helps payers and providers reduce waste and improve healthcare access. — Industry: Healthcare