Job Summary
The DRG Validation Auditor is responsible for examining inpatient claims to verify the accuracy of coding in alignment with medical records and industry standards. This role also involves acting as a subject matter expert for payment integrity while supporting enhancements within the auditing team processes.
Responsibilities
- Review and validate inpatient claims for coding accuracy based on established medical records.
- Provide expert knowledge in payment integrity matters.
- Contribute to process improvement initiatives for the audit team.
Qualifications
- Associate degree from an accredited institution.
- Current credentials from AHIMA, such as RHIT or RHIA.
- Certifications in coding, such as CCS or CIC.
- A minimum of three years of experience in ICD-10 inpatient coding and auditing.
- Clinical experience within a healthcare environment.
