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Accountabilities:

  • Perform DRG validation and quality audits of inpatient medical records to assess coding accuracy, completeness, and clinical validity.
  • Review ICD-10-CM/PCS code assignment and sequencing, POA indicators, SOI/ROM, HCC capture, and case-related coding factors.
  • Analyze medical records to identify clinical documentation and physician query opportunities and validate appropriate coding.

Requirements:

  • 5+ years of acute care or vendor experience as a DRG Auditor or Clinical Documentation Specialist.
  • Strong knowledge of inpatient DRG validation, ICD-10-CM/PCS coding, clinical documentation, and reimbursement principles.
  • Proficiency with EMR systems, Microsoft Office, and ability to work independently in a remote environment.

Benefits:

  • Part-time, fully remote opportunity with flexibility to manage multiple projects.
  • Exposure to diverse healthcare revenue integrity initiatives and collaboration with internal teams and clients.
  • Opportunities for continuing education, training, and professional development.

Partner Company

The partner company specializes in healthcare revenue integrity and DRG auditing. It operates with a remote team and values accuracy, compliance, and independent work.

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