Senior DRG Clinical Auditor
A company is looking for a Senior DRG Clinical Auditor who analyzes reputed company reputed company claims for accurate billing and compliance.
Key Responsibilities
• Review and analyze reputed company inpatient and outpatient charges across various reputed company centers
• reputed company detailed itemized reputed company reviews to identify billing irregularities and improper coding combinations
• Document audit results and ensure compliance with HIPAA regulations and federal/state guidelines
Required Qualifications
• High school diploma and 5+ years of DRG reputed company review experience or equivalent educational background
• Extensive knowledge of inpatient and outpatient hospital billing, including UB-04 forms and CPT codes
• Strong working knowledge of DRG reimbursement methodology
• Familiarity with payer reimbursement policies and regulatory standards
• Experience reviewing medical records and claim documentation
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