California Licensed DRG Integrity Analyst

Job Summary

Dedicated to DRG validation workflows, the full-time California Licensed DRG Integrity Analyst will perform clinical and coding assessments on inpatient encounters, identifying DRG risks and optimization opportunities while working remotely.

Key responsibilities

• Perform initial DRG-focused screening of assigned inpatient charts according to established workflows
• Conduct high-level assessments to identify DRG risk and documentation or coding misalignment
• Document screening outcomes and escalate cases with validated opportunities to Clinical Coding Analysts (CCAs)

Required qualifications

• Minimum one year of experience with inpatient coding and/or clinical documentation integrity
• Working knowledge of MS-DRG and/or APR-DRG methodology
• Experience reviewing inpatient medical records within established workflows
• AHIMA (CCS, RHIT, RHIA, or CDIP) or ACDIS (CCDS) credential required