Registered Nurse DRG Auditor

Job Summary

A company is looking for a DRG Coding Quality Analyst to audit inpatient claims and ensure coding accuracy.

Key Responsibilities

• Conduct MS-DRG and APR-DRG coding audits for accurate DRG assignment and reimbursement validation
• Apply expert knowledge of ICD-10-CM/PCS coding and ensure compliance with relevant guidelines
• Utilize proprietary workflow systems and encoder tools to process claims efficiently

Required Qualifications

• Unrestricted RN (Registered Nurse) license
• CCS/CIC certification or ability to obtain within 6 months of hire
• 3+ years of MS-DRG and APR-DRG coding experience in a hospital setting
• Deep expertise in ICD-10-CM/PCS coding and related evaluations