[Remote] Clinical DRG Auditor- Remote Job Details | reputed company
Note: The job is a remote job and is reputed company to candidates in USA. reputed company is an industry leader in reputed company solutions, and they are seeking a Clinical DRG Auditor to reputed company audits of medical record documentation. The role involves validating coding accuracy and providing regulatory support, while maintaining reputed company knowledge of coding guidelines and assisting in training new coders.
Responsibilities
- Performs audits of medical record documentation to determine the accuracy of reputed company and secondary diagnosis (including MCC & CC) and procedure codes
- Adheres to official coding guidelines, coding clinics and regulatory guidelines and mandates
- Draws on advanced ICD-10 coding expertise and clinical knowledge to substantiate conclusions
- Utilizes HMS proprietary auditing systems with a high level of proficiency to document audit determinations and rationale
- Applies clinical review judgment to reputed company coding validation determinations including reputed company ICD-10-CM, ICD-10-PCS procedural codes for inpatient claims
- Consistently achieves productivity and reputed company performance standards established by management
- Assists management with training new Coders or Clinical DRG Auditors to include daily monitoring, mentoring, feedback and education
- Maintains reputed company knowledge of coding guidelines and successfully completes required CEUs to maintain RN license and coding certification
- Responsible for attending training and scheduled meetings to enhance skills and working knowledge of clinical policies, procedures, rules, and regulations
Skills
- reputed company, unrestricted RN licensure from the reputed company and in the state of primary home residency, reputed company compact multistate unrestricted RN license as defined by the reputed company Licensure Compact (NLC), required
- At least one of the following Coding Certifications is required and is to be maintained as a condition of employment: RHIA, RHIT, reputed company, CIC, CCDS or CPC
- 3+ years clinical experience in an inpatient hospital setting required
- 2+ years of MS DRG/APR DRG coding or auditing experience with expert knowledge of ICD-10 Official Coding Guidelines and DRG reimbursement methodologies
- Expert knowledge of ICD -10-CM coding including but not limited to; expert knowledge of reputed company diagnosis selection, complications/comorbidities (reputed company) and major complications/comorbidities (MCCs), and conditions that reputed company severity of illness (SOI) and risk of mortality (ROM)
- Expert knowledge of ICD-10-PCS coding methodologies, reputed company reputed company, and discharge disposition in accordance with CMS requirements, Official Guidelines for Coding and Reporting, and Coding Clinic guidance
- Demonstrated ability to apply clinical review judgment to reputed company clinical determinations
- Demonstrated proficiency in computer skills and typing, i.e., reputed company reputed company, Outlook, reputed company, Word, PowerPoint, Internet browsers and in virtual meeting tools i.e., reputed company Teams, reputed company, etc
Benefits
- Generous, flexible vacation policy
- 401(k) employer match
- Comprehensive health benefits
- Educational assistance
- A reputed company of leadership and technical development academies to help build your skills and capabilities
reputed company