State Licensed APR DRG Analyst
Job Summary
Collaborating with Payment Integrity Audit program leaders, the remote Senior Manager - APR DRG Concept Development Analyst will research, develop, and implement inpatient DRG audit selection criteria while analyzing performance metrics to ensure alignment with team goals.
Key Responsibilities
- Serve as a subject matter expert for research and analysis to identify overpayment opportunities in APR-DRG validation
- Collaborate with audit and analytic teams to review and monitor concept performance pre-and post-implementation
- Utilize internal selection tools to build queries and test concept effectiveness, delivering insights to senior leaders
Required Qualifications
- 10+ years of inpatient coding or auditing experience with mastery-level expertise in APR-DRG methodology
- Bachelor's degree in health information management, Healthcare Informatics, or Health Care Administration
- Active AHIMA certification (RHIA, RHIT, or CCS)
- Experience with encoder tools (3M, Trubridge) and large data sets
- Proficient in Microsoft Excel, including advanced functions and pivot tables
Complete Job Description
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