Active unrestricted RN license and 2+ years of inpatient payment integrity claim review experience, including DRG validation or itemized bill review. Requires advanced DRG, coding, regulatory, and clinical documentation expertise.Key Responsibilitiesreviewing claimsvalidating diagnoseswriting rationalesSkills & ToolsICD-10, MS-DRG, AP-DRG, APR-DRG, CPT, HCPCS, UpToDate, Merck Manual, Microsoft OfficeJob DetailsCategory: Healthcare Services – NursingSeniority: Entry LevelCommitment: Full TimeWorkplace: Remote — United StatesSalary: USD 54,371 – 117,811 / yearLanguages: EnglishBenefitsRetirement planAbout Molina HealthcareA healthcare organization providing health insurance and care management services. — Industry: Healthcare
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