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Clinical Validation Auditor Job in Alpharetta, Georgia

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Job Title: Clinical Validation Auditor

Employer:Vatica Health
Type:FULL TIME
Job Location:Remote
Skills:Risk Adjustment,ICD 10
Required Certifications:CRC,RN
Required Experience:3 to 4 years
Location:11800 Amber Park Dr. STE 230 Alpharetta 30009, GA, US
* Note: This listing is for a remote position
Date Posted:7/30/2021
Vatica is one of the most innovative and fastest growing healthcare technology companies. We are always looking for great people to join our diverse team. The QI Clinical Validation Auditor will independently review cases, ensuring accurate ICD-10-CM risk adjusted coding and clinical documentation. They will stay abreast of current changes to the Risk Adjustment field and continue education to maintain high level proficiency.


Responsibilities
  • Independently reviews cases, ensuring accurate ICD-10-CM risk-adjusted coding and clinical documentation.
  • Responsible for performing second reviews of QI work as assigned.
  • Stays abreast of current changes to the Risk Adjustment field.
  • Continues education to maintain high level of proficiency in Risk Adjustment field.
  • Maintains RN and CRC certifications.
  • Performs research as needed to determine whether codes are appropriate.
  • Maintains individual 95% IRR score.
  • Maintains required productivity.
  • Executes other responsibilities per business needs.


Requirements
  • RN, with minimum of 3 years of clinical experience
  • Bachelor’s Degree or equivalent combination of education and experience
  • Certified Risk Adjustment Coder Certification and/or 1 year of Risk Adjustment coding experience.
  • Working knowledge of ICD-10 CM guidelines and appropriate clinical documentation.
  • Experience reviewing clinical cases.
  • High level of expertise in navigating EMRs.
  • Proficient in Microsoft Office

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