Clinical Validation

Do you seek out new challenges on a daily basis?

Are you looking for a job that offers you the opportunity to use your clinical and DRG coding validation skills at the highest level?

If so, this could be the opportunity for you to join an accuracy-focused, energetic team!!

VARIS provides overpayment identification services to payers who utilize the Diagnosis Related Group (DRG) methodology for acute inpatient claims payment. We are the only company across the nation focused solely on providing overpayment identification services within DRG and APC-paid claims, while offering a highly trained and experienced team of experts. Thus, our priority is our customers: to reduce their claims overpayments and ensure maximum use of claims payment dollars. To learn more about VARIS, please visit www.varis1.com.

VARIS LLC is looking for a licensed Registered Nurse with clinical validation and ICD-10 CM/PCS coding experience. The candidate should have advanced clinical expertise and extensive knowledge of complex disease processes with broad clinical experience in an inpatient setting. The RN will conduct comprehensive medical record reviews to determine that the requisite clinical criteria and applied coding principles are applied after claims submission.

VARIS LLC is a dynamic organization focused on identifying overpayments for health plan clients.

Join the VARIS Team, where you are not just an employee but part of our close-knit organization! Promoting success and increasing knowledge is a priority of VARIS, we want our employees to become the best of the best.

VARIS’ benefits are highly competitive and rewarding including but not limited to health/dental/vision benefits, 10 paid holidays, 401K with company contribution, generous paid time off, profit sharing, educational opportunities and compensation.

Qualifications

· Registered Nurse (RN), with at least at least 3 years of audit experience in an acute care hospital environment and appropriate certifications, such as an AHIMA issued Certified Coding Specialist (CCS.) Experience in any of the following: claims auditing/quality assurance/recovery auditing – ideally in a DRG / Clinical Validation Audit setting or hospital environment strongly preferred.

· At least three (3) years working with ICD 10-CM/PCS, MS-DRG, and APR-DRG with a broad knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement policies, medical necessity criteria and coding terminology.

· Nursing education (ASN, BSN, or MSN) required. RN license must be maintained as a condition of employment.

· Coding certification required and maintained as a condition of employment (CCS, CIC, CPC, RHIA, RHIT, CCDS or CDIP) or willing to obtain within 6 months of employment.

· Adherence to official coding guidelines, coding clinic determinations and CMS and other regulatory compliance guidelines and mandates. Requires expert coding knowledge – DRG and ICD-10-CM/PCS codes.

· Requires working knowledge of applicable industry-based medical coding and billing standards.

· Proficiency in Word, Access, Excel and other applications.

· Excellent written and verbal communication skills.

Work Environment

· Ability to work independently in a remote environment.

· High Speed internet connection required.

· Ability to meet or exceed both production and quality metrics as assigned.

· Competitive wage based on experience.

· Pre-employment testing includes reference and background checks.

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