DRG / IRF Auditor

This is a fully remote position, open to applicants in United States.

📋 Description

• Execute thorough IRF payment integrity audits utilizing a variety of documents.

• Confirm the completion of IRF-PAI and the accompanying documentation.

• Detect discrepancies in documentation, coding, and reimbursement.

• Analyze client payment methodologies and contractual requirements.

• Develop clear and concise audit conclusions, including rationale and financial implications.

⛳️ Requirements

• A minimum of a High School Diploma is required; higher education is preferred.

• Preferred credentials include CCS, RHIA, RHIT, CIC, or CPC; possessing multiple credentials is strongly favored.

• At least 4 years of experience in inpatient facility coding, auditing, payment integrity, or reimbursement review is essential.

• A solid understanding of ICD-10-CM/PCS, inpatient facility claim review, medical record abstraction, and payer reimbursement methodologies is necessary.

• Proficiency in Excel, Word, OneNote, and general computer skills; experience with audit workflow and encoder/reference tools is preferred.

🏝️ Benefits

• Health insurance

• Dental insurance

• Vision insurance

• 401(k) options

• Flexible work arrangements

• Mentorship and career development programs

• Paid time off