- Review inpatient medical records to validate the accuracy of assigned DRGs
- Ensure compliance with ICD-10-CM/PCS coding guidelines and CMS regulations
- Identify discrepancies in coding or documentation and recommend corrections
- Collaborate with coding teams, CDI specialists, and physicians to clarify documentation
- Conduct audits to detect undercoding, overcoding, or billing errors
- Provide feedback and education to coding staff on DRG optimization and compliance
- Maintain productivity and quality standards for case reviews
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