Inpatient Auditor III

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

📋 Description

• Perform thorough reviews of MS-DRG and APR-DRG coding to ensure precise DRG assignment and reimbursement accuracy.

• Leverage extensive knowledge of coding guidelines and cutting-edge tools to enhance the identification of overpayments.

• Develop clear, succinct, and well-supported audit conclusions in alignment with AHA Coding Clinic Guidelines and ICD-10-CM/PCS regulations.

• Employ advanced DRG encoder tools like 3M and Webstrat to boost the efficiency and accuracy of audits.

• Achieve or surpass EXL quality and productivity benchmarks, including maintaining strong upholding rates for appeals.

• Remain informed about industry trends, coding updates, and compliance regulations.

• Follow HIPAA and EXL policies and procedures to guarantee data security and adherence to regulations.

⛳️ Requirements

• Minimum of a High School Diploma (Higher education is preferred).

• Credentials such as CCS, CIC, CPC, RHIA, or RHIT (Having multiple credentials is preferred).

• At least 4 years of experience in MS-DRG/APR-DRG coding.

• Profound knowledge of AHA Coding Guidelines and DRG reimbursement methodologies.

• Previous experience in auditing for DRG retrospective overpayment identification is highly preferred.

• Strong expertise in using DRG encoder tools, including 3M and Webstrat.

• In-depth inpatient coding knowledge at an expert level.

• Comprehensive understanding of ICD-10-CM/PCS coding guidelines.

• Capacity to work independently in a remote setting.

• Excellent time management, problem-solving, and analytical abilities.

• Strong written and verbal communication skills with a keen attention to detail.

• Proficiency in Excel, Word, and OneNote.

• High level of overall computer literacy.

• Dedication to teamwork, collaboration, and ongoing learning.

• Ability to adhere to HIPAA and EXL policies and procedures.

🏝️ Benefits

• Pay For Performance bonus in addition to the salary range.

• Fully remote work experience from a home office.

• Industry-leading training opportunities.

• Career development pathways.

• Competitive benefits package, including healthcare, vision, dental, and 401(k) options.

• Mentorship and career development initiatives.

• Hands-on experience with top-tier healthcare clients.

• A culture of collaboration, support, and inclusivity.