DRG Validation Auditor I
Based in the United StatesFull-TimeEntry
Salary$48,131.00 – $81,225.49
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Job Details
- Experience
- 3+ years
Requirements
- Active AHIMA credential required (RHIA, RHIT, and/or CCS).
- Minimum of 3+ years of ICD-10 coding and DRG reimbursement experience, including recent acute inpatient auditing exposure.
- Strong familiarity with multiple EMR systems such as Epic, Cerner, and Meditech.
- Solid understanding of inpatient coding guidelines, compliance standards, and documentation practices.
- Excellent analytical skills with high attention to detail and ability to interpret complex clinical records.
- Strong communication skills to clearly document audit findings and recommendations.
Responsibilities
- Review inpatient medical records to validate DRG assignments and ensure coding accuracy and compliance with regulatory standards.
- Analyze clinical documentation within EMR and proprietary systems to identify discrepancies or opportunities for correction.
- Provide clear, evidence-based rationales for all audit findings using recognized industry guidelines.
- Apply authoritative references such as ICD-10 Official Guidelines, AHIMA standards, and AHA Coding Clinics to support decisions.
- Collaborate with internal teams to support documentation improvement and revenue integrity initiatives.
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