Diagnosis Related Group DRG Auditor III jobs in United States
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DS Technologies Inc · 1 month ago

Diagnosis Related Group DRG Auditor III

DS Technologies Inc provides innovative, transformative IT services and solutions. They are seeking a Diagnosis-Related Group (DRG) - Auditor III to conduct comprehensive coding reviews, ensure accuracy in DRG assignment, and maintain compliance with coding guidelines.

Information Technology & Services

Responsibilities

Conduct comprehensive MS-DRG and APR-DRG coding reviews to ensure accuracy in DRG assignment and reimbursement
Apply expert knowledge of coding guidelines and utilize industry-leading tools to maximize overpayment identifications
Craft clear, concise, and well-supported audit findings, backed by AHA Coding Clinic Guidelines and ICD-10-CM/PCS regulations
Utilize advanced DRG encoder tools (such as 3M, Webstrat) to drive efficiency and accuracy in audits
Meet or exceed EXL’s quality and productivity standards, including strong uphold rates for appeals
Stay ahead of industry trends, coding updates, and compliance regulations to maintain expert-level knowledge
Adhere to HIPAA and EXL policies and procedures to ensure data security and regulatory compliance

Qualification

MS-DRG codingAHA Coding GuidelinesDRG encoder toolsICD-10-CM/PCS codingCCS credentialRHIA credentialRHIT credentialAnalytical skillsExcel proficiencyWord proficiencyOneNote proficiencyTime managementProblem-solvingWritten communicationVerbal communicationTeamworkCollaborationContinuous learning

Required

Minimum High School Diploma
CCS, RHIA, or RHIT credential
4+ years of MS-DRG/APR-DRG coding experience with a deep understanding of AHA Coding Guidelines and DRG reimbursement methodologies
Strong proficiency with DRG encoder tools (3M, Webstrat)
Expert-level inpatient coding knowledge with an in-depth understanding of ICD-10-CM/PCS coding guidelines
Self-motivated and able to work independently in a remote environment while maintaining high performance
Exceptional time management, problem-solving, and analytical skills
Strong written and verbal communication with attention to detail
Proficient in Excel, Word, and OneNote, with strong overall computer literacy
Passion for DRG auditing and a commitment to teamwork, collaboration, and continuous learning

Preferred

Higher education preferred
Multiple credentials preferred
Prior experience in DRG retrospective overpayment identification auditing is highly desirable

Benefits

401(k)
401(k) matching
Dental insurance
Health insurance
Paid time off

Company

DS Technologies Inc

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DS Technologies Inc - SUCCESS IS OUR DUTY At DS Technologies, we’re more than just a technology provider – we’re your strategic partner in navigating the digital revolution.

Funding

Current Stage
Growth Stage
Company data provided by crunchbase