DRG Coding Reviewer/Auditor

Job Description: • 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. Apply tot his job