Molina Healthcare is seeking a registered nurse to support inpatient and outpatient clinical claim review activities. You will verify diagnoses, procedures, revenue codes, and DRG assignments to ensure accurate reimbursement and compliance with coding guidelines.
The role involves independent review, evidence-based rationale, and collaboration with related teams. Ideal candidates have RN licensure, DRG expertise, and familiarity with ICD-10, CPT/HCPCS, and UHDDS.
#J-18808-LjbffrRemote DRG & Coding Validation Specialist in workfromhome at Unknown Company
This position is listed as full time and onsite.