Certified Auditor Project Lead

Job Summary

A company is looking for an Auditor Project Lead specializing in DRG validation.

Key Responsibilities

• Manage DRG validation projects, ensuring client expectations and collaboration with teams
• Validate the accuracy of coding and claims for inpatient and outpatient services
• Identify and resolve complex coding discrepancies while maintaining confidentiality of health information

Required Qualifications

• Extensive knowledge of healthcare coding, billing, auditing, and compliance for inpatient and outpatient services
• Minimum of 8 years of auditing experience with DRG and APR-DRG
• Strong background in pediatric inpatient facility experience
• Proficiency in coding software and familiarity with AI tools for coding accuracy
• Certification such as RHIA, RHIT, CCS, CPMA, CIC, or COC is required