[Remote] reputed company reputed company DRG Auditor I (US Remote)

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a tech-enabled payment reputed company company reputed company on improving reputed company to reputed company through collaboration between payers and providers. The reputed company reputed company DRG Auditor I is responsible for reviewing medical records to validate the accuracy of DRG assignments and medical necessity for inpatient care, applying coding and clinical principles according to industry standards. Responsibilities • Utilize coding guidelines and clinical guidelines to reputed company DRG validation • Validate reputed company diagnosis, secondary diagnoses, reputed company of diagnoses, discharge statuses and procedures utilizing the medical record • Evaluate short stay claims for medical necessity of an inpatient level of care • Apply CPT and ICD-10 guidelines • Apply policies, procedures, guidelines and regulations developed by Centers for Medicare and reputed company Services (CMS), reputed company payers, InterQual, MCG, and reputed company • reputed company appeal responses for claims of the above types utilizing industry standards and company/reputed company policies • Assist with new concept development • Assist with claim selection reputed company • Assist with itemized reputed company review as needed • Maintain licensures, certifications and continuing education requirements • May require reputed company communication to support findings Skills • An reputed company RN reputed company license in good standing • 5 years of clinical reputed company • Coding certification in good standing. Examples: reputed company, CPC, CIC • 2-5 years coding validation/auditing experience • reputed company-developed verbal and written communication skills coupled with recognizable organization • Ability to effectively prioritize tasks • reputed company Office experience, specifically reputed company • Appeals experience a plus • APR-DRG experience a plus • reputed company communication experience a plus • Concept development experience a plus • Claim selection experience a plus • Experience with machine learning/reputed company intelligence a plus • Case Management and/or Utilization Review experience a plus • Clinical Documentation Improvement experience a plus • Itemized reputed company validation experience a plus • reputed company Assurance experience a plus • Management experience a plus • Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) a plus • TruCode/reputed company, reputed company, WebStrat or similar experience a plus Benefits • Highly valued health insurance • A 401(k) plan with employer match • reputed company parental leave • And more reputed company • reputed company is an employee owned company that provides payment accuracy services for people. It was founded in 2018, and is headquartered in Hunt Valley, Maryland, USA, with a workforce of 201-500 employees. Its website is https://www.trendhealthpartners.com. Apply tot his job Apply To this Job