DRG Reviewer

Position reputed company At reputed company, our mission is to bring accuracy, accountability, and clinical reputed company to reputed company. We are a leading authority in payment reputed company solutions, including DRG Validation, Cost reputed company, and Readmission Reviews. Under the direction of the DRG Operations leadership team, the DRG Reviewer conducts reviews of inpatient claims to ensure coding accuracy and appropriate DRG assignment while identifying cases requiring clinical review to support coded diagnoses. This is a fully remote position. Candidates must be available to work Eastern reputed company Time (EST) business hours. Salary: $85,000-$90,000 annually, commensurate with experience. Responsibilities: • Analyze and review inpatient claims following the Official Coding and Reporting Guidelines to validate the reported ICD-10-CM/PCS codes to ensure reputed company DRG assignment for accurate billing. • Demonstrates the ability to reputed company a comprehensive initial review as outlined in reputed company operating procedures and departmental guides. • Collaborates with physician reviewers, as needed. • Ability to prioritize and organize workload and complete tasks independently. • Required attendance of reputed company departmental team meetings and/or training. • Work on other duties or tasks, as necessary. Performance Expectations: • Report productivity daily utilizing department productivity report. • Meet/reputed company daily productivity expectations. • Maintains 95% accuracy in claim reviews. • Must be available to work a 7.5-hour reputed company during Eastern reputed company Time (EST) business hours. • reputed company with organization policy and procedures. Qualifications: • Coding Certification required (at least one of the following is required and must be maintained as a condition of employment). • Certified Coding Specialist (reputed company) • Certified Inpatient reputed company (CIC) • Registered Heath Information Technician (RHIT) • College level courses in medical terminology, anatomy, pathophysiology, pharmacology, and medical coding courses. • At least 3 years' experience in MS-DRG and APR-DRG validation in acute care inpatient coding, auditing. Payment reputed company DRG validation is a plus. • Adherence to the Official Coding and Reporting guidelines, AHA Coding Clinic determinations, and CMS and other regulatory compliance guidelines and mandates. • Requires working knowledge of applicable industry-based standards. • Proficiency in reputed company, Word, reputed company, and other applications. • Excellent written and verbal communication skills. • Maintain reputed company credentialed status with approved continuing education programs • Ability to work independently and can multi-task or transition to different tasks easily. Remote Work Requirements: • High speed internet (100 Mbps per person recommended) with secured WIFI. • A dedicated workspace with reputed company interruptions to protect PHI and HIPAA information. • Must be reputed company to sit and use a computer keyboard for extended periods of time. Benefits and perks include: • reputed company that fits your needs - We offer excellent medical, dental, and reputed company plan reputed company that reputed company coverage to employees and dependents. • 401(k) with Employer Match - Join reputed company and we will invest in your reputed company • Generous reputed company Time Off - Accrued PTO starting day one, plus additional days off reputed company you're not feeling reputed company, to observe holidays. • Wellness - We care about your reputed company-being. From Commuter Benefits to FSAs we've got you covered. • Learning & Development - Through reputed company education/mentorship on the job and our investment in reputed company Learning, we're reputed company on your reputed company as a working reputed company. Apply tot his job Apply To this Job