DRG Validation Coding Auditor

🕒 June 4

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Ensemble Health Partners

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

⚕️ Healthcare Insurance

☁️ SaaS

🏢 Enterprise

💰 Private Equity Round on 2022-03

Healthcare Insurance • SaaS • Enterprise

Ensemble Health Partners is a leading provider of revenue cycle management (RCM) services for healthcare organizations. They offer an end-to-end RCM solution that helps hospitals, health systems, and affiliated physician groups optimize their revenue cycles, reduce denials and underpayments, and enhance patient experiences using a combination of expert management and advanced technology. Ensemble Health Partners leverages certified operators and AI to deliver consistent results, improve collections, and support future growth for healthcare providers. They are recognized for their robust client partnerships and commitment to delivering reliable revenue lift and cost savings for their clients.

📋 Description

• Perform documentation and coding audits for all acute inpatient services for clients • Identify coding errors, compliance, and educational opportunities • Optimize reimbursement by ensuring that diagnosis/procedure codes and supporting documentation accurately support the services rendered • Perform independent reviews, interpret medical records, and apply in-depth knowledge of coding principles • Conduct DRG (ex. MS, APR, Tricare) coding and clinical reviews • Maintain productivity and quality goals as set by audit leaders • Write clear, accurate and concise recommendations • Ensure acute inpatient coding audits are completed accurately and timely

🎯 Requirements

• 5+ years of coding experience • 3+ years of facility coding audit experience (such as DRG and APC Validation) • Proficiency in multiple EMR’s, encoders, and the Microsoft Office suite • Educated in HIPAA regulations; must maintain strict confidentiality of patient and client information • Consistently achieves quality and productivity standards • Ability to organize and complete work in a timely manner • Ability to read, write and effectively communicate in English • Ability to understand medical/surgical terminology • Above average written and verbal communication skills • Must be inquisitive and demonstrate openness to innovation including AI to explore better processes and ways to alleviate friction and improve patient and client experiences.

🏖️ Benefits

• Bonus Incentives • Paid Certifications • Tuition Reimbursement • Comprehensive Benefits • Career Advancement