Auditor

• 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.

DRG Coding Reviewer/Auditor

Clinical Eligibility Auditor

Eligibility Staff Auditor

Senior Internal Auditor

Senior IT Internal Auditor

Agency Auditor