Inpatient DRG Validator, Coding Analyst

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

📋 Description

• Conduct thorough inpatient coding and clinical validation assessments.

• Analyze cases utilizing MS-DRG and APR-DRG methodologies.

• Assess Hospital-Acquired Conditions (HACs), Patient Safety Indicators (PSIs), and Elixhauser metrics.

• Assist healthcare organizations in enhancing coding accuracy, compliance, quality, and reimbursement.

• Achieve set productivity, quality, and performance goals.

• Uphold a high level of accuracy and meticulous attention to detail.

• Collaborate with a skilled U.S.-based Revenue Integrity Optimization team.

• Contribute to initiatives in coding, clinical quality, and revenue integrity.

⛳️ Requirements

• A minimum of one required credential: Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), or Certified Inpatient Coder (CIC).

• At least 5 years of experience in inpatient coding, Clinical Documentation Improvement (CDI), DRG validation, or revenue integrity.

• At least 3 years of experience working as a DRG validator.

• Advanced proficiency in ICD-10-CM and ICD-10-PCS coding systems.

• Strong grasp of MS-DRG and APR-DRG methodologies.

• Exceptional analytical, written, and verbal communication abilities.

• High level of computer literacy.

• Capability to navigate electronic medical record (EMR) systems, DRG grouping software, Microsoft applications, and other necessary technology platforms.

• Preferred: Certified Documentation Integrity Practitioner (CDIP) or Clinical Documentation Integrity Specialist (CDIS).

• Preferred: Familiarity with payer reimbursement methodologies.

• Preferred: Experience with quality indicators, PSIs, HACs, and risk-adjustment methodologies.

• Preferred: Previous consulting or client-facing experience.

• Preferred: Understanding of compliant physician query practices and clinical validation assessments.

• Must possess legal authorization to work in the United States.

• This position is not eligible for employment visa sponsorship now or in the future.

🏝️ Benefits

• Competitive salary along with a comprehensive benefits package tailored to support team members and their families.

• Access to continuing education units (CEUs).

• Reimbursement for qualifying credential renewals.

• Opportunities for professional development and career progression.

• A collaborative, supportive, and highly engaged team environment.

• Chance to expand skills and embrace new challenges.

• Work alongside an experienced U.S.-based team.