Drg Coding Reviewer

Summary

Join MedReview, a leader in payment integrity solutions, as a full-time, remote Coding Professional! This role requires analyzing inpatient claims, validating ICD-10-CM/PCS codes, and ensuring accurate DRG assignments. You will collaborate with physician reviewers and maintain professional credentials. We offer a competitive benefits package including healthcare, 401k matching, generous PTO, and professional development opportunities. A coding certification (RHIA, RHIT, CCS, or CIC) is required, along with at least one year of MS-DRG and APR-DRG coding experience. High-speed internet and a dedicated workspace are essential for remote work.

Requirements

• Coding Certification required (at least one of the following is required and must be maintained as a condition of employment). Registered Health Information Administrator (RHIA)
• Registered Heath Information Technician (RHIT)
• Certified Coding Specialist (CCS)
• Certified Inpatient Coder (CIC)
• College level courses in medical terminology, anatomy, pathophysiology, pharmacology, and medical coding courses
• At least 1 year of experience in MS-DRG and APR-DRG coding experience through acute care inpatient coding, auditing, and/or payment integrity DRG Validation
• Adherence to the Official Coding and Reporting guidelines, AHA Coding Clinic determinations, and CMS and other regulatory compliance guidelines and mandates
• Requires working knowledge of applicable industry-based standards
• Proficiency in Outlook, Word, Excel, and other applications
• Excellent written and verbal communication skills
• Maintain professional credentialed status with approved continuing education programs
• Ability to work independently and can multi-task or transition to different tasks easily
• High speed internet (100 Mbps per person recommended) with secured WIFI
• A dedicated workspace with minimal interruptions to protect PHI and HIPAA information
• Must be able to sit and use a computer keyboard for extended periods of time

Responsibilities

• Analyze and review inpatient claims following the Official Coding and Reporting Guidelines to validate the reported ICD-10-CM/PCS codes to ensure proper DRG assignment for accurate billing
• Demonstrates the ability to perform a comprehensive initial review as outlined in the standard operating procedures and departmental guides
• Collaborates with physician reviewers, as needed
• Ability to prioritize and organize workload and complete tasks independently
• Required attendance of all departmental team meetings and/or training
• Work on other duties or tasks, as necessary

Preferred Qualifications

Certified Clinical Documentation Specialist (CCDS), Certified Documentation Improvement Practitioner (CDIP) or Certified Professional Coder (CPC)

Benefits

• Healthcare that fits your needs - We offer excellent medical, dental, and vision plan options that provide coverage to employees and dependents
• 401(k) with Employer Match - Join the team and we will invest in your future
• Generous Paid Time Off - Accrued PTO starting day one, plus additional days off when you’re not feeling well, to observe holidays
• Wellness - We care about your well-being. From Commuter Benefits to FSAs we’ve got you covered
• Learning & Development - Through continued education/mentorship on the job and our investment in LinkedIn Learning, we’re focused on your growth as a working professional