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Position Summary:
- Responsible for reviewing post-billed inpatient claims to identify and validate missed reimbursement opportunities.
- Requires CCS certification and deep understanding of ICD-10 coding and DRG methodology.
Key Responsibilities:
- Review inpatient claims imported into the DRG database for coding accuracy.
- Analyze weekly hospital billing files to identify underpaid claims.
- Make reimbursement improvement recommendations and submit findings for client review.
Requirements and Qualifications:
- Associate's or bachelor's degree in health information management or related field.
- Certified Coding Specialist (CCS) certification required.
- 2-3 years experience in DRG validation or inpatient medical coding.
Special Considerations and Prerequisites:
- This role is remote, with extensive computer and document review work.
- Must handle PHI with confidentiality and professionalism.
- Strong analytical skills and attention to detail required.
EnableComp
EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations using intelligent automation. They are a multi-year Top Workplaces award recipient and have been on the Inc. 5000 list of fastest-growing private companies for eleven years.