State Licensed DRG Auditor

A company is looking for a DRG Auditor to validate ICD-10 diagnosis and procedure codes, DRG assignments, and discharge statuses billed by hospitals. Key Responsibilities Conduct MS-DRG and APR-DRG coding reviews to verify accuracy of DRG assignment and identify overpayments Perform clinical coding reviews to ensure accuracy of medical coding using clinical expertise Write clear and concise rationales in support of findings using ICD-10 CM/PCS Official Coding Guidelines Required Qualifications Unrestricted RN (registered nurse) CCS/CIC certification or willingness to obtain within 6 months of hire 3+ years of MS DRG and APR DRG coding experience in a hospital environment Expert knowledge of ICD-10 Official Coding Guidelines and DRG reimbursement methodologies Solid command of anatomy and physiology, diagnostic procedures, and surgical operations

Apr 23, 2025 - 23:27

A company is looking for a DRG Auditor to validate ICD-10 diagnosis and procedure codes, DRG assignments, and discharge statuses billed by hospitals. Key Responsibilities Conduct MS-DRG and APR-DRG coding reviews to verify accuracy of DRG assignment and identify overpayments Perform clinical coding reviews to ensure accuracy of medical coding using clinical expertise Write clear and concise rationales in support of findings using ICD-10 CM/PCS Official Coding Guidelines Required Qualifications Unrestricted RN (registered nurse) CCS/CIC certification or willingness to obtain within 6 months of hire 3+ years of MS DRG and APR DRG coding experience in a hospital environment Expert knowledge of ICD-10 Official Coding Guidelines and DRG reimbursement methodologies Solid command of anatomy and physiology, diagnostic procedures, and surgical operations