DRG Quality Analyst IV – Healthcare

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

📋 Description

• Utilize clinical expertise for DRG audits to guarantee the precision of inpatient DRG coding.

• Assess the accuracy and consistency of the work produced by clinical DRG auditors.

• Ensure that audits are properly flagged for findings as well as for no findings.

• Provide mentorship to Clinical DRG auditors.

• Suggest process improvements to enhance quality and performance.

• Engage in communication with colleagues and management.

• Conduct root cause analysis on identified errors.

• Execute other assigned duties as necessary.

• Carry out job responsibilities in alignment with company policies on Compliance, Information Security, and Regulatory standards.

⛳️ Requirements

• At least 5 years of experience in clinical validation audits.

• Active Coding Certification: CIC, CCS, CPC, RHIT, or RHIA.

• Exceptional auditing and monitoring capabilities.

• Proficiency in mentoring and instructing others.

• Strong decision-making abilities and sound judgment.

• Comprehensive understanding of medical terminology and human physiology.

• Robust technical skills and a quick ability to learn new systems.

• Excellent verbal/presentation and written communication abilities.

• Capability to complete tasks effectively and resolve issues within established timelines.

• Strong organizational skills with meticulous attention to detail.

• Ability to collaborate in a team environment as well as work independently when necessary.

• Proven flexibility and adaptability in various situations.

• Must possess the ability to work under pressure and make independent decisions in diverse circumstances.

• Requires a high level of accuracy across various responsibilities.

• Proficient personal computer skills are essential.

• Must be self-driven to complete tasks punctually and meet deadlines.

• Strong interpersonal skills are mandatory.

• A brief coding/auditing assessment may be part of the interview process.

🏝️ Benefits

• Opportunity to work remotely / from home.

• Benefits information can be found at https://www.exlservice.com/us-careers-and-benefits.