Clinical RN Chart Reviewer, (Remote) CIC or CCS certified
Summary
A remote Clinical RN Chart Reviewer role at a healthcare management company, performing medical chart reviews and coding assessments for inpatient records. Requires active RN license plus CIC or CCS coding certification; involves ensuring coding accuracy and compliance in a managed care environment.
Job Role
The Clinical RN Chart Reviewer will perform clinical reviews of medical records and other documentation to validate issues of claims coding accuracy, medical necessity, and the appropriateness of treatment settings and services delivered. The Clinical RN Chart Reviewer will report to the Payment Assurance Senior Manager and support a culture and work environment that promotes and inspires an active, continuous improvement philosophy regarding products and services in line with our company mission. This role requires certified coding expertise and a strong understanding of DRG validation, medical necessity, and regulatory guidelines.