DRG Auditor

Job Summary

A company is looking for a Revenue Integrity DRG Auditor.

Key Responsibilities

• Achieve and maintain assigned client financial performance goals
• Validate code and DRG assignment based on clinical documentation and coding guidelines
• Assist in prediction enhancements to increase verification rates

Required Qualifications, Training, and Education

• 3+ years of inpatient auditing/coding experience with ICD and CPT/HCPCS
• In-depth knowledge of hospital inpatient coding, clinical documentation, and payer reimbursement methodologies
• Experience with MS-DRG and APR-DRG validation
• Relevant coding or clinical certifications such as CCS, CPC, RHIT, RHIA, CDIP, or CCDS preferred
• Proficient in Microsoft Office and capable of working with computerized programs and databases