Machinify
DRG Reviewer (Onsite - Hendersonville, TN)
US · Staff+
Sponsorship not specified$90k-$110kDetected 49 days ago
ComplianceAuditingOperations ManagementIntellectual PropertyCustomer SupportHIPAAICD-10LeadershipCommunicationCollaborationTime ManagementMicrosoft Office
About the role
- Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plan clients across the country.
- This position is an onsite audit position that requires the DRG Reviewer to live in the commutable vicinity of Nashville, TN and be able to go onsite daily to the facilities as scheduled.
- Pay range: $90,000-$110,000 This is an exempt position.
Responsibilities
- Collaboration: Collaborate with team leaders to ensure DRG denial is thoroughly reviewed.
- Coding Knowledge: Maintains expert knowledge of ICD-10-CM/PCS coding conventions and rules, Official Coding Guidelines and American Hospital Association (AHA) Coding Clinic.
- Quality and Time Management: Perform all audits in observance of organizational quality and timeliness standards set by the audit operations management team, meets productivity requirements
- Collaborate with team leaders to ensure DRG denial is thoroughly reviewed.
- Demonstrated ability to gain support for ideas and lead others to accomplish objectives.
Requirements
- Associate or bachelor's degree in nursing (active/unrestricted license)
- Proficiency: Utilizes proprietary auditing systems and intellectual property with a high level of proficiency to make sound and consistent audit determinations and rationales
- National certification as Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), and/or Certified Coding Specialist (CCS).
- Associate or bachelor's degree in health information management
- RHIA - Registered Health Information Administrator
- RHIT- Registered Health Information Technician
- CCDS - Certified Clinical Documentation Specialist
- CDIP - Clinical Documentation Improvement Practitioner
Skills
- Participates in exit interviews with the client summarizing audit findings, which can vary depending on client/ facility
- Practice Standards: Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association.
- Other duties as assigned.
- Minimum of five years hospital inpatient coding for IPPS reimbursement and/or at least 2 years' experience performing DRG validation.
- Previous auditing/ recovery experience preferred.
- Excellent oral and written communication skills.
- Comprehensive knowledge of the DRG structure and regulatory requirements
- Education (required)
- Associate or bachelor's degree in nursing (active/unrestricted license); or
- Associate or bachelor's degree in health information management; or
- Work experience may be considered in lieu of formal education at leadership discretion
- Certification (at least one of the following is required)
Compensation
- $90,000-$110,000
- This is an exempt position. The salary range is for Base Salary. Compensation will be determined based on several factors including, but not limited to, skill set, years of experience, and the employee's geographic location.
Benefits
- We're constantly reimagining what's possible in our industry, creating disruptively simple, powerfully clear ways to maximize financial outcomes and drive down healthcare costs.
- Assures HIPAA compliance for protected health information.
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This listing is sourced directly from Machinify's careers page and normalized into a canonical job model.