Provision People
Summary:
Our direct client is seeking a remote DRG Auditor/Coder to ensure the accuracy and integrity of inpatient claims. The role involves reviewing medical records and billed claims to validate coding, ensure compliance with guidelines, correct errors, and optimize revenue through precise DRG assignment.
Key Responsibilities: Review and validate inpatient claims per Official Coding and Reporting Guidelines (ICD-10-CM/PCS). Audit medical records to confirm documentation supports coded diagnoses and procedures. Identify and correct coding or documentation errors to improve revenue integrity. Collaborate with physicians and clinical staff on complex or ambiguous cases.
Required Qualifications: Active Certified Coding Specialist (CCS) or Certified Inpatient Coder (CIC) certification (mandatory). Minimum 3 years of acute care inpatient coding/auditing experience, including MS-DRG and APR-DRG validation.
Preferred Skills: Experience in Payment Integrity or utilization review/DRG validation.
Key Responsibilities: Review and validate inpatient claims per Official Coding and Reporting Guidelines (ICD-10-CM/PCS). Audit medical records to confirm documentation supports coded diagnoses and procedures. Identify and correct coding or documentation errors to improve revenue integrity. Collaborate with physicians and clinical staff on complex or ambiguous cases.
Required Qualifications: Active Certified Coding Specialist (CCS) or Certified Inpatient Coder (CIC) certification (mandatory). Minimum 3 years of acute care inpatient coding/auditing experience, including MS-DRG and APR-DRG validation.
Preferred Skills: Experience in Payment Integrity or utilization review/DRG validation.