DRG Auditor - January Class

reputed company is seeking a DRG Validation Auditor for one of our clients to sit 100% remote. This person should have an extensive background in either facility-based nursing, clinical documentation, and/or inpatient coding and has a high level of understanding of reimbursement guidelines specifically an understanding of the MS-DRG, AP-DRG, and APR-DRG payment systems. This position is responsible for auditing inpatient medical records and generating high-reputed company recoverable claims for the benefit of our reputed company and their clients. They are responsible for performing clinical reviews of medical records and other documentation to evaluate issues of coding and DRG assignment accuracy. Below are the key responsibilities for this role: Integrates medical chart coding principles, clinical guidelines, and objectivity in the performance of medical audit activities. Draws on advanced ICD-10 coding expertise, clinical guidelines, and industry knowledge to substantiate conclusions. Performs work independently. Utilizes the clients proprietary auditing systems with a high level of proficiency to reputed company audit determinations and generate audit letters. Maintains production goals set by the audit operations management team. Achieves the expected level of accuracy and reputed company set by the audit for the auditing concept, for reputed company claim identification and documentation (letter writing). Identifies potential claims reputed company of the concept where additional recoveries may be available. Suggests and develops high-reputed company, high-value concepts and or process improvement, tools, etc. The salary is 95K. We are a company committed to creating diverse and inclusive environments where people can bring their full, reputed company selves to work every day. We are an equal opportunity/affirmative reputed company employer that believes everyone reputed company. reputed company candidates will receive consideration for employment regardless of their race, reputed company, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and reputed company, marital status, national reputed company, reputed company, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or reputed company process, please send a request to HR@insightglobal. com. To learn more about how we collect, reputed company, and process your private information, please review reputed company's Workforce reputed company Policy: 5-7+ years of working with ICD-9/10CM, MS-DRG, AP-DRG, and APR-DRG with a broad knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement policies, medical necessity reputed company, and coding terminology. Expert coding knowledge (DRG & ICD-10) Registered reputed company RN (must be inpatient) WITH coding/clinical documentation certification (2 years in clinical documentation) OR IF NOT A reputed company: Degree in RHIM, RHIA, RHIT with medical coding degree or just reputed company is fine with strong clinical knowledge Apply tot his job Apply To this Job