Job Overview:We are seeking an experienced Inpatient Coding Auditor specializing in DRG validation to review medical records and ensure the accuracy of Diagnosis Related Group assignments. This role focuses on validating inpatient coding, evaluating clinical documentation, and ensuring compliance with CMS regulations and coding guidelines.The ideal candidate has strong inpatient coding experience, deep knowledge of DRG assignment, and the ability to analyze clinical documentation to ensure accurate coding and reimbursement.Key Responsibilities:Review inpatient medical records to validate accurate DRG assignment and coding complianceAnalyze patient charts to identify discrepancies in coding or clinical documentationEnsure coding accuracy according to CMS regulations and industry coding guidelinesConduct second-level reviews of DRGs, discharge dispositions, and Present on Admission (POA) indicators prior to billingCollaborate with coding teams and clinical staff to resolve documentation and coding questionsParticipate in coding audits and quality improvement initiativesResearch and respond to coding or documentation denials related to DRG assignmentsProvide guidance and education to coding staff regarding documentation and coding best practicesSupport regulatory compliance and internal audit activitiesRequired Qualifications:Minimum of 5 years of inpatient coding experienceExperience with DRG validation, auditing, or coding quality reviewStrong understanding of clinical documentation and coding compliance standardsAbility to work independently in a remote environmentStrong analytical and communication skillsEducation:Associate's or Bachelor's degree in Health Information Management or a related field preferredRequired Certification:Candidates must hold at least one of the following credentials:RHIARHITCCSCPCCCS-PTechnical Knowledge:Strong understanding of DRG assignment and coding guidelinesFamiliarity with UB-04 billing standards and CMS regulationsExperience reviewing clinical documentation for coding accuracyBenefits:Competitive hourly compensationComprehensive medical, dental, and vision coverageThree weeks of paid vacationFully remote work environmentOpportunity to work in a specialized coding and compliance role within healthcare operationsSchedule: Full-timeTravel: Initial onsite orientation during the first week with occasional additional travel as needed

Inpatient Coding Auditor - DRG Validation (Remote)

Emma

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Language(s) required:

John Heymach

About Next Move Healthcare:

www.nextmovehealthcare.com/

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