Inpatient DRG Auditor

Job Summary

Focused on Coding & Clinical Chart Validation, the full-time Inpatient DRG Auditor will conduct audits of inpatient DRG claims, ensuring coding accuracy and appropriateness of treatment settings while utilizing proprietary auditing systems.

Key responsibilities

• Audits inpatient DRG claims using medical chart coding principles and client-specific guidelines
• Utilizes audit tools to generate determinations and maintain productivity and accuracy standards
• Identifies potential claims for additional recoveries and contributes to process improvement initiatives

Required qualifications

• Associate or bachelor's degree in Health Information Management (RHIA or RHIT) or equivalent experience in claims auditing
• Current coding/CDI certification such as RHIA, RHIT, CPC, CCS, CIC, CDIP, or CCDS
• 5 to 7+ years of experience with ICD-9/10CM, MS-DRG, and related coding systems
• Expert knowledge of official coding guidelines and compliance regulations
• Proficiency in Microsoft Office applications and strong organizational skills