Coder DRG Auditor I

Job Description: • Review medical records and associated claim information to validate accuracy of DRG assignments and/or Itemized Billing • Apply coding principles based on industry standards and company/client guidelines • Validate principal diagnosis, secondary diagnoses, sequencing of diagnoses, discharge statuses and procedures utilizing the medical record • Apply policies, procedures, guidelines and regulations developed by Centers for Medicare and Medicaid Services (CMS), commercial payers, InterQual, MCG, and Trend Health Partners • Validate itemized bill payments utilizing the UB-04, the itemized bill and industry/client coding guidelines • Provide appeal responses for claims of the above types utilizing industry standards and company/client policies • Assist with new concept development • Assist with claim selection criteria • Maintain certifications and continuing education requirements • May require client communication to support findings Requirements: • Coding certification in good standing. Examples: CCS, CPC, CIC • Coding validation/auditing experience • Well-developed verbal and written communication skills coupled with recognizable organization • Ability to effectively prioritize tasks • Microsoft Office experience, specifically Excel Benefits: • highly valued health insurance • 401(k) plan with employer match • paid parental leave • comprehensive compensation package Apply tot his job Apply To this Job