DRG Validator/Reviewer

📋 Description Review post-billed inpatient claims for DRG accuracy and reimbursement. Analyze weekly hospital billing files to identify underpaid claims using ICD-10. Map clinical documentation to ICD-10 codes to ensure DRG accuracy. Identify and correct undercoding or misclassification of diagnoses and procedures. Use Health ROI edits to detect high-value opportunities (dialysis, embolization, catheterization). Make reimbursement recommendations for client review and approval. 🎯 Requirements Associate's or bachelor's in health information management or related field; RHIT/RHIA encouraged. CCS certification required. 2-3 years’ DRG validation or inpatient coding experience. Strong ICD-10-CM/PCS, DRG reimbursement knowledge; hospital billing processes. Proficient in reading/interpreting clinical documentation across departments. Post-bill coding experience; DRG software; MS Office (Word, Excel, Outlook).