lever
Coder DRG Auditor I
Trend Health Partners
Remote, USA
Full-time
Entry
Remote
USD 65000-85000 yearly / year
Discovered 1 weeks ago
Microsoft OfficeTruCodeTruBridge3MWebStratInterQual
Free
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Key Skills for This Role
Microsoft OfficeTruCodeTruBridge3MWebStratInterQual
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- Utilize coding guidelines to perform DRG validation
- Validate principal diagnosis, secondary diagnoses, sequencing of diagnoses, discharge statuses and procedures utilizing the medical record
- Apply CPT and ICD-10 guidelines
- Apply policies, procedures, guidelines and regulations developed by Centers for Medicare and Medicaid Services (CMS), commercial payers, InterQual, MCG, and Trend Health Partners
- Validate itemized bill payments utilizing the UB-04, the itemized bill and industry/client coding guidelines
- Provide appeal responses for claims of the above types utilizing industry standards and company/client policies
- Assist with new concept development
- Assist with claim selection criteria
- Maintain certifications and continuing education requirements
- May require client communication to support findings
- Coding certification in good standing. Examples: CCS, CPC, CIC
- Coding validation/auditing experience
- Well-developed verbal and written communication skills coupled with recognizable organization
- Ability to effectively prioritize tasks
- Microsoft Office experience, specifically Excel
- Appeals experience a plus
- APR-DRG experience a plus
- Client communication experience a plus
- Concept development experience a plus
- Claim selection experience a plus
- Experience with machine learning/artificial intelligence a plus
- Clinical Documentation Improvement experience a plus
- Quality Assurance experience a plus
- Management experience a plus
- Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) a plus
- TruCode/TruBridge, 3M, WebStrat or similar experience a plus
- This position will be exposed mainly to an indoor office environment and will be expected to work in or around computers and printers.
- The nature of the work is sedentary, and the employee will be sitting most of the time.
- Essential physical functions of the job include typing and the repetitive motion to utilize computer software and hardware continuously throughout the day.
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