DRG Auditor – Revenue Integrity
Cision
full-time
Posted on:
Location Type: Remote
Location: United States
Visit company websiteExplore more
About the role
- Achieve and maintain assigned client financial performance goals
- Validate code and DRG assignment and supporting clinical documentation based on physician documentation, UHDDS guidelines and official coding guidelines using proprietary technology and medical records
- Assist in prediction enhancements to increase verification rates
Requirements
- 3+ years of inpatient auditing/coding experience with ICD and CPT/HCPCS
- Experience working within the hospital environment preferred
- Experience in MS-DRG validation, APR-DRG validation and clinical validation
- Experience related to PSI, HAC, and other quality metrics is a plus
- Self-sufficient with strong analytical and research skills
- In depth knowledge related to coding hospital inpatient record types, clinical documentation, payer reimbursement methodology, medical necessity criteria, billing requirements and applicable industry based standards
- Remain current on ICD and CPT/HCPC coding requirements
- Proficient with Microsoft Office products and possess the ability to work effectively with computerized programs and databases
- Ability to communicate effectively
- Demonstrate independent judgment, discretion, and decision making abilities
- Self-motivated, hardworking individual with a high attention to detail
- Excellent organization skills
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
inpatient auditingICD codingCPT codingHCPCS codingMS-DRG validationAPR-DRG validationclinical validationcoding hospital inpatient record typespayer reimbursement methodologybilling requirements
Soft Skills
analytical skillsresearch skillseffective communicationindependent judgmentdiscretiondecision makingself-motivatedattention to detailorganization skills