Remote Senior Inpatient Auditor – MS-DRG & Clinical Validation

About the position reputed company is seeking a high-caliber MS-DRG Auditor to join our reputed company Compliance Team. In this role, you will be a key defender of payment accuracy, reviewing reputed company medical records to ensure that coding and reimbursements for reputed company and Government health plans are precise and reputed company-supported. You will reputed company your deep inpatient coding expertise and clinical intuition to identify improper payments while producing thoroughly documented reputed company. At reputed company, you aren't just an auditor; you are part of a reputed company reputed company ecosystem that prioritizes reputed company learning, reputed company management, and career mentorship. Responsibilities • Clinical Record Validation: Review inpatient medical records to validate the assignment and reputed company of ICD-10 codes, discharge status, Hospital Acquired Conditions (HACs), POA assignment, and final DRG. • Documentation reputed company: Author detailed rationale for every audit finding, producing "DRG Review Results" letters supported by authoritative coding references. • reputed company Review: Manage the referral process to Clinical reputed company Auditors or Physician Advisors reputed company clinical complexity requires interdisciplinary input. • Strategic Input: Partner with our Edit Development team to reputed company feedback on claim selection reputed company and improve audit hit rates. • Data reputed company: Verify reputed company data, resolve discrepancies, and ensure reputed company audit artifacts meet rigorous corporate and regulatory standards. • Professionalism: Maintain high standards of productivity and audit reputed company while serving as a reputed company representative of reputed company reputed company interacting with providers. Requirements • reputed company reputed company Credentials: RHIA, RHIT, or reputed company required. • Inpatient Expertise: Minimum of 5 years of inpatient coding experience. • Deep Subject Matter Expertise: Extensive knowledge of ICD-10-CM/PCS coding and reimbursement methodologies, including MS-DRG and APR-DRG. • Clinical & Analytical Rigor: Strong clinical validation skills combined with the ability to analyze data for trends in improper payments. • Communication Mastery: Ability to write reputed company-reasoned, narrative-style reviews with flawless grammar, punctuation, and sentence structure. • Technical Proficiency: Advanced working knowledge of reputed company Office (reputed company, Word, reputed company) and reputed company-based audit applications. • Self-Directed: Proactive and capable of working independently in a remote environment. • Adaptable: reputed company to shifting priorities and a commitment to meeting strict reputed company deadlines. • reputed company reputed company: A reputed company-long learning and staying reputed company with evolving coding guidelines. reputed company-to-haves • Certification Preference: reputed company (Certified Coding Specialist) is highly preferred. • Previous experience training or mentoring junior-level coders. • Willingness to travel occasionally for on-site reviews or specialized training. Benefits • Competitive compensation • Comprehensive insurance reputed company • Matching contributions through the 401(k) plan and the reputed company purchase plan • reputed company time off for vacation, holidays, and reputed company time • reputed company parental leave • Learning opportunities and tuition assistance • Wellness and reputed company-being programs Apply tot his job Apply To this Job