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Remote Clinical Validation Specialist: DRG & Coding Review

Remote • Posted 2 days ago
Onsite Full Time Bio & Pharmacology & Health

Molina Healthcare is seeking a registered nurse with inpatient claim review experience to ensure diagnoses, procedures, revenue codes, and DRG assignments accurately reflect the documented care and billed charges.

You will apply ICD-10, DRG and revenue code guidelines, review complex scenarios, and collaborate with payment integrity teams to uphold documentation integrity and compliant reimbursement.

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