State Licensed DRG Auditor
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Job Summary
As a full-time remote State Licensed DRG Auditor, the Associate Auditor (Analyst) will validate coding updates impacting diagnosis-related groups on claims, ensuring compliance and potential reimbursement while evaluating coding opportunities and documenting recommendations.
Key responsibilities:
- Validate coding updates that affect diagnosis-related group claims and provide education for clients
- Document evidence-based recommendations and support findings with industry-recognized references
- Audit specific rule sets and pre-screen opportunities for the DRG Validation Auditing Team
Required qualifications:
- High school diploma or equivalent experience
- Four or more years of ICD-10 coding and DRG reimbursement experience, including recent acute inpatient coding
- Current AHIMA credential, such as RHIA, RHIT, and/or CCS
- Experience with multiple electronic medical record systems, such as Epic, Cerner, and Meditech
- Passing score of 80% on the Auditor I assessment
Complete Job Description
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