DRG Validation Auditor -Contractor

DRG Validation Auditor -Contractor is a remote role that involves validating the accuracy of ICD-10-CM, ICD-10-PCS, and DRG and APR group appropriateness, CPT and HCPCS inpatient patient and outpatient facility claims. The ideal candidate needs to have both inpatient and outpatient coding / auditing background focused on pediatric healthcare services and coding accuracy and payer claim processing. Requirements • Extensive knowledge of healthcare industry and experience in and around coding, billing, auditing, compliance and reimbursement for Inpatient and Outpatient facility • 5 years of auditing facility inpatient and outpatient services with DRG and APR-DRG as well as familiarity with clinical documentation improvement practices • Proficiency in coding software, electronic health record systems and familiar with how AI tools can assist in identifying over/under-assigned DRGs Benefits • Competitive salary • Opportunity to work in a dynamic environment with a high-performing team • Chance to inform the next generation in auditing software Apply Job!