The Judge Group
Job Title:
Clinical DRG Coding Auditor Job Type:
Contract to Hire Location:
Remote (Telecommute) Work Hours:
Standard business hours (Monday–Friday) Rate:
$55.00/hourly
Position Overview: We are seeking a highly skilled and detail-oriented Clinical DRG Coding Auditor to join our team remotely. This role focuses on conducting MS-DRG and APR-DRG coding reviews to ensure accurate DRG assignment and reimbursement, with a strong emphasis on identifying overpayments. The ideal candidate will possess expert-level knowledge of ICD-10-CM/PCS coding, DRG methodologies, and clinical documentation standards.
Primary Responsibilities: Conduct comprehensive MS-DRG and APR-DRG coding reviews to validate DRG assignment and reimbursement accuracy. Identify and assign ICD-10-CM/PCS codes, ensuring correct sequencing, POA indicators, and discharge disposition per CMS guidelines. Apply ICD-10 Official Coding Guidelines and AHA Coding Clinic guidance fluently in daily coding review activities. Utilize clinical expertise to assess documentation and determine appropriate code and billing assignments. Demonstrate advanced understanding of anatomy, physiology, diagnostic procedures, and surgical operations for accurate ICD-10-PCS coding. Draft clear, concise, and well-supported audit rationales referencing official coding guidelines and clinical documentation. Efficiently navigate proprietary workflow systems and encoder tools to complete audit determinations and manage claim workflows. Stay current with coding guideline updates, reimbursement trends, and client-specific requirements. Manage daily case review assignments with a strong focus on quality and productivity. Collaborate with investigative and analytical teams to provide clinical coding support and expertise.
Required Qualifications: Unrestricted RN license CCS (Certified Coding Specialist) or CIC (Certified Inpatient Coder) Minimum of 3 years of MS-DRG/APR-DRG coding experience in a hospital setting. Expert-level knowledge of ICD-10-CM coding, including principal diagnosis selection, CC/MCC identification, and SOI/ROM impact. Advanced proficiency in ICD-10-PCS coding, including root operations, body systems, approaches, devices, and qualifiers. Proficiency in using Windows PC and multitasking across multiple applications. Strong written and verbal communication skills. Exceptional analytical skills and attention to detail. Ability to work independently in a remote setting and consistently deliver high-quality results.
Clinical DRG Coding Auditor Job Type:
Contract to Hire Location:
Remote (Telecommute) Work Hours:
Standard business hours (Monday–Friday) Rate:
$55.00/hourly
Position Overview: We are seeking a highly skilled and detail-oriented Clinical DRG Coding Auditor to join our team remotely. This role focuses on conducting MS-DRG and APR-DRG coding reviews to ensure accurate DRG assignment and reimbursement, with a strong emphasis on identifying overpayments. The ideal candidate will possess expert-level knowledge of ICD-10-CM/PCS coding, DRG methodologies, and clinical documentation standards.
Primary Responsibilities: Conduct comprehensive MS-DRG and APR-DRG coding reviews to validate DRG assignment and reimbursement accuracy. Identify and assign ICD-10-CM/PCS codes, ensuring correct sequencing, POA indicators, and discharge disposition per CMS guidelines. Apply ICD-10 Official Coding Guidelines and AHA Coding Clinic guidance fluently in daily coding review activities. Utilize clinical expertise to assess documentation and determine appropriate code and billing assignments. Demonstrate advanced understanding of anatomy, physiology, diagnostic procedures, and surgical operations for accurate ICD-10-PCS coding. Draft clear, concise, and well-supported audit rationales referencing official coding guidelines and clinical documentation. Efficiently navigate proprietary workflow systems and encoder tools to complete audit determinations and manage claim workflows. Stay current with coding guideline updates, reimbursement trends, and client-specific requirements. Manage daily case review assignments with a strong focus on quality and productivity. Collaborate with investigative and analytical teams to provide clinical coding support and expertise.
Required Qualifications: Unrestricted RN license CCS (Certified Coding Specialist) or CIC (Certified Inpatient Coder) Minimum of 3 years of MS-DRG/APR-DRG coding experience in a hospital setting. Expert-level knowledge of ICD-10-CM coding, including principal diagnosis selection, CC/MCC identification, and SOI/ROM impact. Advanced proficiency in ICD-10-PCS coding, including root operations, body systems, approaches, devices, and qualifiers. Proficiency in using Windows PC and multitasking across multiple applications. Strong written and verbal communication skills. Exceptional analytical skills and attention to detail. Ability to work independently in a remote setting and consistently deliver high-quality results.