CorroHealth
DRG Revenue Integrity Auditor - REMOTE
US - Remote · Full-time
Sponsorship not specifiedDetected 1 day ago
Data AnalysisExcelHIPAAEHR/EMRICD-10LeadershipCommunicationMicrosoft Office
About the role
- The DRG - A will utilize International Classification of Diseases - Clinical Modification (CM) and Procedure Coding System (PCS) Terminology to ensure accurate coding.
- Responsible for validating proper sequencing and accuracy of ICD-10-CM/PCS codes, POA assignments, severity of illness (SOI), risk of mortality (ROM), Hierarchical Condition Category (HCC) capture CMI and other coding factors.
- Usage of most current Clinical Criteria, MCG, InterQual, payers' Clinical Policy Bulletins, CMS Guidelines, NCDs and/or LCDs.
Responsibilities
- This position may perform all or most of the primary duties listed below.
- Maintain quality of reviews and making sure the true clinical picture is captured, along with ensuring chart review productivity
- When interacting with clients, always conducts themselves in a professional manner, exhibiting excellent relationship, work performance and communication skill so as to support the company and its business interests
Requirements
- Regular eye-hand coordination and manual dexterity is required to operate office equipment.
- The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required.
- Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs.
- Available to provide training to other new hires, if required, along with supporting development of training materials, as well as clinical, coding and CDI policies
- Additionally, DRG - A may also be required to audit clients' clinical documentation integrity (CDI) program to include query review, analysis of coding, and overall program accuracy.
- To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.
- The list below is representative of the knowledge, skill and/or ability required.
Nice to have
- Five or more years working in an acute care setting or a third-party vendor as a DRG Auditor or Clinical Documentation Specialist (CDS).
Skills
- Experience with telecommuting and electronic medical record systems required
- Good computer skills and familiarity with commonly used work apps, such as MS Word, MS Excel, MS Outlook, Teams, etc.
- Strong analytical skills
- Works well with numbers, using basic math skills
- Strong team player
- Ability to work with multiple and diverse clients and projects
- Ability to switch between multiple clients throughout the day and week
- Ability to work with minimal supervision
- Ability to maintain and access multiple files
- It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities.
Benefits
- Medical, Dental, Vision coverage, 401K with match
- Long-term disability insurance, life insurance and more
- Holidays Time and ample paid time off
- Maintenance of professional credentials and knowledge of CDI, coding, reimbursement, and compliance issues through continuing education
Company info
- Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals.
- We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success.
- Our purpose is to help clients exceed their financial health goals.
- Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs.
- Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals.
- We build long-term careers by investing in YOU.
- We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success.
- Responsible to keep up with your company and EMR access log ins and passwords.
- The company has reviewed this job description to ensure that the essential functions and basic duties have been included.
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This listing is sourced directly from CorroHealth's careers page and normalized into a canonical job model.