MedReview Inc.

DRG Coding Reviewer/Auditor

MedReview Inc.

full-time

Posted on:

Location Type: Remote

Location: Remote • 🇺🇸 United States

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Salary

💰 $85,000 - $90,000 per year

Job Level

Mid-LevelSenior

About the role

  • Analyze and review inpatient claims following the Official Coding and Reporting Guidelines to validate the reported ICD-10-CM/PCS codes to ensure proper DRG assignment for accurate billing.
  • Demonstrates the ability to perform a comprehensive initial review as outlined in the standard operating procedures and departmental guides.
  • Collaborates with physician reviewers, as needed.
  • Ability to prioritize and organize workload and complete tasks independently.
  • Required attendance of all departmental team meetings and/or training.
  • Work on other duties or tasks, as necessary.
  • Report productivity daily utilizing department productivity report.
  • Meet/exceed daily productivity expectations.
  • Maintains 95% accuracy in claim reviews.
  • Required to work a 7.5-hour workday within the company’s core hours.
  • Comply with organization policy and procedures.

Requirements

  • Coding Certification required (at least one of the following is required and must be maintained as a condition of employment).
  • Certified Coding Specialist (CCS)
  • Certified Inpatient Coder (CIC)
  • Registered Heath Information Technician (RHIT)
  • College level courses in medical terminology, anatomy, pathophysiology, pharmacology, and medical coding courses.
  • At least 3 years’ experience in MS-DRG and APR-DRG validation in acute care inpatient coding, auditing.
  • Payment integrity DRG validation is a plus.
  • Adherence to the Official Coding and Reporting guidelines, AHA Coding Clinic determinations, and CMS and other regulatory compliance guidelines and mandates.
  • Requires working knowledge of applicable industry-based standards.
  • Proficiency in Outlook, Word, Excel, and other applications.
  • Excellent written and verbal communication skills.
  • Maintain professional credentialed status with approved continuing education programs.
  • Ability to work independently and can multi-task or transition to different tasks easily.
Benefits
  • Healthcare that fits your needs - We offer excellent medical, dental, and vision plan options that provide coverage to employees and dependents.
  • 401(k) with Employer Match - Join the team and we will invest in your future
  • Generous Paid Time Off - Accrued PTO starting day one, plus additional days off when you’re not feeling well, to observe holidays.
  • Wellness - We care about your well-being. From Commuter Benefits to FSAs we’ve got you covered.
  • Learning & Development - Through continued education/mentorship on the job and our investment in LinkedIn Learning, we’re focused on your growth as a working professional.

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard skills
ICD-10-CMICD-10-PCSMS-DRG validationAPR-DRG validationmedical codingauditingpayment integrity DRG validationmedical terminologyanatomypathophysiology
Soft skills
ability to prioritizeorganizational skillsindependent workexcellent written communicationexcellent verbal communicationmulti-taskingcollaborationattention to detailproductivity reportingadherence to guidelines
Certifications
Certified Coding Specialist (CCS)Certified Inpatient Coder (CIC)Registered Health Information Technician (RHIT)