JOB SUMMARY:Support the Director of Health Information Management (HIM) by conducting comprehensive claim audits and reviewing hospital outpatient and professional fee (ProFee) claims for coding accuracy, revenue integrity, and billing compliance. Utilizing proprietary software, this role evaluates coding opportunities, identifies revenue cycle improvement recommendations, and assists clients in optimizing claim quality and reimbursement outcomes. The ideal candidate is an experienced outpatient ...
The DRG Revenue Integrity Auditor (DRG - A) performs Diagnostic Related Group (DRG) validation and quality audits on Inpatient charts. The DRG - A will perform chart reviews and will ensure that all reviewed charts capture the patient s true clinical picture from the codes assigned by the facility s coders in compliance with federal laws. The DRG - A will utilize International Classification of Diseases - Clinical Modification (CM) and Procedure Coding System (PCS) Terminology to ensure accurate ...
JOB SUMMARY:The DRG Revenue Integrity Auditor (DRG - A) performs Diagnostic Related Group (DRG) validation and quality audits on Inpatient charts. The DRG - A will perform chart reviews and will ensure that all reviewed charts capture the patient s true clinical picture from the codes assigned by the facility s coders in compliance with federal laws. The DRG - A will utilize International Classification of Diseases - Clinical Modification (CM) and Procedure Coding System (PCS) Terminology to ...
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