Medical Policy Analyst RN
Location: REMOTE Salary: $45.00 USD Hourly - $48.00 USD Hourly Description: Our client is currently seeking a REMOTE - Medical Policy Analyst RN Job Title: Clinical Documentation & Coding Review Nurse Type: 6-month contract with strong potential to convert to permanent Location: Remote — candidates must reside in NJ, PA, NY, CT, or MD Compensation: Competitive and based on experience Position Overview: This role focuses on conducting comprehensive clinical documentation and coding reviews to ensure accurate billing practices and compliance with regulatory standards. The ideal candidate brings strong clinical judgment, advanced coding expertise, and a commitment to quality improvement across inpatient care settings.
Key Responsibilities
- Review clinical records to validate appropriate billing practices using industry-standard coding resources.
- Apply critical thinking and clinical judgment to determine accurate clinical and coding outcomes for individual cases.
- Provide recommendations that support quality improvement initiatives and care plan development.
- Conduct DRG validation and clinical validation reviews, along with other inpatient coding assessments as needed.
- Maintain up-to-date knowledge of ICD‑10 coding principles, government billing regulations, and compliance protocols.
Required Qualifications
- Active NJ RN license or Compact RN license.
- Minimum 3 years of acute care inpatient clinical experience.
- Minimum 3 years of hospital inpatient coding experience using ICD‑10 diagnosis and procedure coding within the last 2 years.
- Strong working knowledge of DRG assignment, validation processes, and regulatory requirements.
- Proficiency in medical record review, chart audits, and clinical documentation analysis.
- Knowledge of CPT/HCPCS, ICD‑10‑CM, and ICD‑10‑PCS coding conventions and rules.
- Experience with coding systems, claims processing, and data management platforms.
- Familiarity with evidence‑based care guidelines/MCG is a plus. Preferred Certifications
- CIC, COC, CPMA, CPCO (highly desirable) By providing your phone number, you consent to: (1) receive automated text messages and calls from the Judge Group, Inc. and its affiliates (collectively "Judge") to such phone number regarding job opportunities, your job application, and for other related purposes. Message & data rates apply and message frequency may vary. Consistent with Judge's Privacy Policy, information obtained from your consent will not be shared with third parties for marketing/promotional purposes. Reply STOP to opt out of receiving telephone calls and text messages from Judge and HELP for help. Contact: [email protected] This job and many more are available through The Judge Group. Find us on the web at www.judge.com Remote About the Company: Judge Group The Judge Group Inc., is a leading professional services firm specializing in talent, technology, and learning solutions. We consult, staff, train, and solve. Through our work we make people and organizations better. Our services are successfully delivered through a network of more than 30 offices across the United States, Canada, and India. The Judge Group is proud to partner with the best and brightest companies in business today, including over 60 of the Fortune 100. We serve organizations in financial services, healthcare, life sciences, insurance, government (including aerospace and defense), manufacturing, and technology and telecommunications. If you would like to learn more about The Judge Group visit www.judge.com or call toll free (800) 360-4474. Company Size: 5,000 to 9,999 employees Industry: Computer/IT Services Founded: 1970 Website: Apply tot his job
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