What You'll Bring to Zelis: Registered Nurse licensure preferred Inpatient Coding Certification required (i.e., CCS, CIC, RHIA, RHIT) 5+ years reviewing and/or auditing ICD-10 CM, MS-DRG, and APR-DRG claims preferred Solid understanding of audit techniques, identification of revenue opportunities, and financial negotiation with providers Experience and working knowledge of Health Insurance, Medicare guidelines, and various healthcare programs Strong understanding of hospital coding and billing rules Clinical and critical thinking skills to evaluate appropriate coding Strong organization skills with attention to detail Excellent communication skills both verbal and written, and skilled at developing and maintaining effective working relationships Demonstrated thought leadership and motivation skills, a self-starter with an ability to research and resolve issues. As part of the Price Optimization division, this role is responsible for conducting post-service, pre-payment and post pay comprehensive inpatient DRG Quality Assurance reviews in an effort to increase the savings achieved for Zelis clients.