DRG Integrity Specialist - Remote

Overview

The DRG Integrity Specialist is responsible for performing secondary level reviews of medical records and code assignments to ensure accurate DRG assignment in compliance with federal and client-specific coding regulations.

In Short

• Review pre-bill cases with a physician to validate diagnosis and procedure codes.
• Utilize Accuity technology for tracking coding errors and data collection.
• Research and respond to inquiries regarding compliance and coding issues.
• Maintain high dependability and meet coding accuracy standards.
• Interact with physicians and management regarding documentation and regulations.
• Assist in process improvement recommendations for productivity and quality.
• Develop and adapt client procedures to align with Accuity methodology.
• Provide education and training on coding practices and compliance.
• Attend training sessions for updates on coding regulations.
• Ensure confidentiality of patient medical records.

Requirements

• High School Diploma or GED required; Associate's Degree preferred.
• Minimum 4 years of inpatient coding experience.
• Minimum 2 years of related experience.
• Coding credential from AHIMA/AAPC required.
• Knowledge of auditing concepts and coding guidelines.
• Strong communication and interpersonal skills.
• Ability to analyze and solve problems critically.
• Knowledge of legal and regulatory compliance issues.
• Ability to work independently in a remote or on-site environment.

Benefits

• Flexible work environment.
• Opportunity for professional development.
• Collaborative team culture.
• Access to ongoing training and resources.