Director, Pre-Bill DRG Review – Quality Assurance, Training & Education

Vaga não está no LinkedIn

🕒 Julho 24

🇺🇸 Estados Unidos – Remoto (EUA)

⏰ Tempo Integral

🔴 Especialista

🔧 Engenheiro de QA (Qualidade de Software)

🦅 Patrocina Visto H1B

Esta empresa já patrocinou vistos H1B no passado.

Candidatar-se

Encontrar Vagas Remotas Similares

Configurar Alerta de Email para Novas Vagas

📊 Verifique sua pontuação de currículo para esta vaga

Melhore suas chances de conseguir uma entrevista verificando sua pontuação de currículo antes de se candidatar.

Enviar Currículo

CorroHealth

SiteLinkedInTodas as Vagas

5001 - 10000 funcionários

🏥 Saúde

⚕️ Seguro de Saúde

☁️ SaaS

Healthcare • Healthcare Insurance • SaaS

CorroHealth é um provedor líder de análises de saúde clinicamente orientadas e soluções impulsionadas por tecnologia, focado em melhorar o desempenho financeiro de hospitais e sistemas de saúde. Suas soluções integradas e tecnologias avançadas visam otimizar todo o ciclo de receita, oferecendo serviços como gestão do ciclo de receita, documentação clínica, codificação médica e gestão de recusas. Com um compromisso de melhorar a saúde financeira por meio de tecnologia inteligente e orientação especializada, a CorroHealth aborda complexas relações entre pagadores e prestadores e apoia operações de saúde eficientes.

Descrição

• Lead the organization's internal pre-bill DRG validation program, ensuring coding accuracy, DRG integrity, and compliance • Design, implement, and continuously improve the quality assurance framework for pre-bill coding review • Build and lead training and education infrastructure for coding staff, CDI specialists, and auditors • Partner with HIM leadership, CDI, Compliance, Revenue Cycle, and Physician Advisors to reduce DRG mismatches and denials • Establish and maintain a QA framework for coding and DRG validation • Set and monitor performance benchmarks and report trends to senior leadership • Manage a team of DRG validators, quality auditors, and/or training specialists

🎯 Requisitos

• Bachelor's degree in Health Information Management, Nursing, Health Administration, or related field required • Master's degree preferred • Certification RHIA, RHIT, CCS, or CDIP required (one or more) • CCDS or CCS-P a plus • Active, unencumbered credential required; must be maintained throughout employment • 7+ years of progressive experience in inpatient coding, DRG validation, clinical documentation integrity, or coding quality/compliance auditing • 3+ years of leadership or management experience, including oversight of quality assurance and/or training functions • Demonstrated expertise in MS-DRG and APR-DRG methodology, ICD-10-CM/PCS coding, and CMS regulatory requirements • Experience designing and delivering adult education/training programs in a healthcare coding or clinical setting • Prior experience with pre-bill review, second-level review, or denials/appeals management strongly preferred

🏖️ Benefícios

• Competitive salary commensurate to related experience • Quality of life with a remote predictable, full-time schedule • Medical, Dental, Vision coverage + more • 401K with company match • Long-term disability insurance, and life insurance • Ample parental leave • Certification and Tuition Reimbursement • Holidays and Flexible paid time off