DRG Validation Auditor

Job Summary

A company is looking for a DRG Validation Auditor - Contractor.

Key Responsibilities

• Validate the accuracy of coding for inpatient and outpatient facility claims
• Audit inpatient claims to ensure accurate DRG code assignment and reimbursement
• Identify and resolve complex coding discrepancies and communicate findings to the team

Required Qualifications and Education

• Extensive knowledge of healthcare coding, billing, auditing, and compliance
• Minimum of 5 years of experience in auditing inpatient and outpatient services
• Strong background in pediatric inpatient facility coding
• Proficiency in coding software and electronic health record systems
• Certification such as RHIA, RHIT, CCS, CPMA, CIC, or COC is required