DRG (Coding) Reviewer / Auditor

Position Summary At MedReview, our mission is to bring accuracy, accountability, and clinical excellence to healthcare.  As such, we are a leading authority in payment integrity solutions including DRG Validation, Cost Outlier and Readmission reviews.

Under the direction of the DRG Operations Department leaders, the DRG Reviewer will conduct reviews of inpatient claims for both coding accuracy as well as perform screening referrals for clinical support of coded diagnoses.

Responsibilities :

• Analyze and review inpatient claims following the Official Coding and Reporting Guidelines to validate the reported ICD-10-CM / PCS codes to ensure proper DRG assignment for accurate billing.
• Demonstrates the ability to perform a comprehensive initial review as outlined in the standard operating procedures and departmental guides.
• Collaborates with physician reviewers, as needed.
• Ability to prioritize and organize workload and complete tasks independently.
• Required attendance of all departmental team meetings and / or training.
• Work on other duties or tasks, as necessary.

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