MedReview Inc. helps payors identify inaccurate medical claims to save millions in overpayments.

DRG Coding Reviewer/Auditor

AuditorAuditorFull TimeRemoteTeam 201-500H1B No SponsorCompany Site LinkedIn

Location

United States

Posted

149 days ago

Salary

$85K - $90K / year

Professional Certificate3 yrs expEnglish

Job Description

• Analyze and review inpatient claims following the Official Coding and Reporting Guidelines to validate the reported ICD-10-CM/PCS codes to ensure proper DRG assignment for accurate billing. • Demonstrates the ability to perform a comprehensive initial review as outlined in the standard operating procedures and departmental guides. • Collaborates with physician reviewers, as needed. • Ability to prioritize and organize workload and complete tasks independently. • Required attendance of all departmental team meetings and/or training. • Work on other duties or tasks, as necessary. • Report productivity daily utilizing department productivity report. • Meet/exceed daily productivity expectations. • Maintains 95% accuracy in claim reviews. • Required to work a 7.5-hour workday within the company’s core hours. • Comply with organization policy and procedures.

Job Requirements

Coding Certification required (at least one of the following is required and must be maintained as a condition of employment).
Certified Coding Specialist (CCS)
Certified Inpatient Coder (CIC)
Registered Heath Information Technician (RHIT)
College level courses in medical terminology, anatomy, pathophysiology, pharmacology, and medical coding courses.
At least 3 years’ experience in MS-DRG and APR-DRG validation in acute care inpatient coding, auditing.
Payment integrity DRG validation is a plus.
Adherence to the Official Coding and Reporting guidelines, AHA Coding Clinic determinations, and CMS and other regulatory compliance guidelines and mandates.
Requires working knowledge of applicable industry-based standards.
Proficiency in Outlook, Word, Excel, and other applications.
Excellent written and verbal communication skills.
Maintain professional credentialed status with approved continuing education programs.
Ability to work independently and can multi-task or transition to different tasks easily.

Benefits

Healthcare that fits your needs - We offer excellent medical, dental, and vision plan options that provide coverage to employees and dependents.
401(k) with Employer Match - Join the team and we will invest in your future
Generous Paid Time Off - Accrued PTO starting day one, plus additional days off when you’re not feeling well, to observe holidays.
Wellness - We care about your well-being. From Commuter Benefits to FSAs we’ve got you covered.
Learning & Development - Through continued education/mentorship on the job and our investment in LinkedIn Learning, we’re focused on your growth as a working professional.