Trend Health Partners

Coder DRG Auditor I

Trend Health Partners

full-time

Posted on:

Location Type: Remote

Location: United States

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Salary

💰 $65,000 - $85,000 per year

About the role

  • Review medical records and associated claim information to validate accuracy of DRG assignments and/or Itemized Billing
  • Apply coding principles based on industry standards and company/client guidelines
  • Validate principal diagnosis, secondary diagnoses, sequencing of diagnoses, discharge statuses and procedures utilizing the medical record
  • Apply policies, procedures, guidelines and regulations developed by Centers for Medicare and Medicaid Services (CMS), commercial payers, InterQual, MCG, and Trend Health Partners
  • Validate itemized bill payments utilizing the UB-04, the itemized bill and industry/client coding guidelines
  • Provide appeal responses for claims of the above types utilizing industry standards and company/client policies
  • Assist with new concept development
  • Assist with claim selection criteria
  • Maintain certifications and continuing education requirements
  • May require client communication to support findings

Requirements

  • Coding certification in good standing. Examples: CCS, CPC, CIC
  • Coding validation/auditing experience
  • Well-developed verbal and written communication skills coupled with recognizable organization
  • Ability to effectively prioritize tasks
  • Microsoft Office experience, specifically Excel
Benefits
  • highly valued health insurance
  • 401(k) plan with employer match
  • paid parental leave
  • comprehensive compensation package
Applicant Tracking System Keywords

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

Hard Skills & Tools
coding principlesDRG assignmentsitemized billingdiagnosis validationcoding validationauditing experienceclaim selection criteria
Soft Skills
verbal communicationwritten communicationorganizationtask prioritization
Certifications
CCSCPCCIC