DRG Validator

Remote Inpatient ICD-10-CM/PCS DRG Auditor

Work from home position

Full Time position with full benefits

Essential Functions and Responsibilities

?      Performs analysis of medical records and provider claims to validate appropriate DRG and ICD-10-CM/PCS code assignment, including complex medical and surgical cases

?      Ensures that assigned codes and DRGs are supported by clinical documentation utilizing payer-specific clinical criteria

?      Applies Official Guidelines for Coding and Reporting consistently and appropriately

?      Provides detailed written explanations to support or rebut coding/DRG recommendations

Qualifications

Required:

●      CCS credential from AHIMA; or a CIC or CPC credential from AAPC

● or more years of Inpatient/DRG auditing experience in an acute care setting or payer setting

●      Expertise in ICD-10-CM/PCS, IPPS/MS-DRG and APR-DRG methodology and logic

●    ...