DRG Auditor

📋 Description Review post-billed inpatient claims in DRG database to identify missed reimbursement opportunities. Analyze weekly hospital billing files to find underpaid claims based on ICD-10 codes. Conduct medical record reviews to verify accuracy of submitted diagnoses/procedures. Navigate medical records and target sections per system edits and flagged items. Match clinical documentation to ICD-10 codes ensuring DRG accuracy. Identify and correct under coded or misclassified diagnoses/procedures. 🎯 Requirements Associate's or bachelor's in health information management or related field; RHIT/RHIA encouraged. Certified Coding Specialist (CCS) certification required. 2-3 years in DRG validation, inpatient coding, or related coding review. Strong understanding of ICD-10-CM/PCS, DRG reimbursement, and hospital billing. Proficient in reading/interpreting clinical documentation across departments. Experience in post-bill coding and DRG software/billing databases.