DRG Revenue Integrity Auditor

Job not on LinkedIn

🔥 0 minutes ago

🇺🇸 United States – Remote

⏱ Part Time

🟡 Mid-level

🟠 Senior

🔎 Auditor

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CorroHealth

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

🏥 Healthcare

⚕️ Healthcare Insurance

☁️ SaaS

Healthcare • Healthcare Insurance • SaaS

CorroHealth is a leading provider of clinically led healthcare analytics and technology-driven solutions, focused on enhancing the financial performance of hospitals and health systems. Their integrated solutions and advanced technologies aim to optimize the entire revenue cycle, offering services such as revenue cycle management, clinical documentation, medical coding, and denials management. With a commitment to improving financial health through intelligent technology and expert guidance, CorroHealth addresses complex payer-provider relationships and supports efficient healthcare operations.

📋 Description

• Perform DRG validation and quality audits on inpatient charts • Validate sequencing and accuracy of ICD-10-CM/PCS codes, POA status, SOI/ROM, HCC capture, and other coding factors • Ensure coded data aligns with federal regulations and organizational standards • Analyze charts for potential query opportunities and confirm correct coding and sequencing • Perform audits of client Clinical Documentation Integrity (CDI) programs when assigned • Apply current clinical criteria, payer bulletins, CMS regulatory guidance, NCDs/LCDs, and official coding guidelines • Stay up to date on clinical guidance, coding clinics, and coding regulations • Provide training, shadowing, and support for new hires when requested • Assist in developing training materials and updates to clinical, coding, and CDI policies • Support internal and external project data analysis, reporting, and feedback • Maintain strict confidentiality of PHI and client information • Communicate professionally with coworkers and clients, promoting teamwork and knowledge sharing • Meet or exceed assigned productivity and accuracy metrics • Participate in mandatory meetings, trainings, and continuing education activities • Maintain company and EMR access credentials and comply with security requirements • Perform additional duties as assigned by management

🎯 Requirements

• Five or more years of experience in an acute care setting or third-party vendor as a DRG Auditor or Clinical Documentation Specialist (CDS) • Experience working remotely and with electronic medical record (EMR) systems • Proficiency with MS Word, Excel, Outlook, Teams, and other standard software • Strong analytical skills and comfort working with numerical data • Ability to manage multiple diverse clients and switch between projects as needed • Strong teamwork orientation and ability to work effectively with minimal supervision • Ability to maintain and organize multiple files and work in a fast-paced environment • Must maintain company and EMR access credentials and comply with security requirements • Ability to perform computer-based work for 6–8 hours a day • Ability to lift and move material weighing up to 20 lbs. infrequently • Preferred: Prior experience as a CDI or coding auditor (not required)

🏖️ Benefits

• Professional development and personal growth opportunities • Training, shadowing, and support for new hires when requested • Continuing education activities • Reasonable accommodations for individuals with disabilities