What are the responsibilities and job description for the Remote Inpatient DRG Coding Auditor RN position at CSI Companies?
Job Summary
The Remote Inpatient DRG Coding Auditor RN is primarily responsible for validating diagnosis and procedure codes, DRG assignments, and discharge statuses using industry-standard and proprietary tools to identify overpayments. This role is essential for ensuring accuracy and compliance in inpatient billing practices.
Pay : $34.50 – 41.50 an hour based on experience.
Hours : Full Time - Monday-Friday Normal Business Hours (Ex. 8am-5pm, 7 : 30-4pm etc.)
Why this Opportunity?
Top ranked company in Fortune’s “World’s Most Admired Companies” 14 years in a row.
This healthcare client is ranked number one in key attributes of reputation : Innovation People management Social responsibility Quality of Management Financial soundness Long-term investment value Quality of products Services and global competitiveness
Status :
Temp to Perm position. This position will go permanent with this Fortune 100 company, and upon hire they will be eligible for outstanding benefits, 3 weeks of PTO, extremely low full coverage medical coverage, and much more When you convert, this could very likely be eligible for a pay increase as well.
Effective Date / Tentative Start Date : Interviewing Immediately
Job Duties :
Conduct MS-DRG and APR-DRG coding reviews to verify DRG assignments and reimbursement accuracy with a focus on identifying overpayments
Accurately assign ICD-10-CM / PCS codes, ensure proper code sequencing, and determine present on admission (POA) status and discharge disposition in compliance with CMS requirements
Apply current ICD-10 Official Coding Guidelines and AHA Coding Clinic guidance to validate claims
Perform clinical coding reviews and utilize clinical expertise to ensure accuracy and compliance in billing
Demonstrate proficiency in anatomy, physiology, diagnostic procedures, and surgical operations to support accurate code assignments
Draft clear, concise rationales for audit findings using coding guidelines and clinical documentation
Leverage proprietary workflow systems and encoder tools efficiently to process claims and document audit outcomes
Stay current with updates to coding guidelines, reimbursement trends, and client-specific requirements
Manage daily case review assignments, prioritizing quality and productivity
Provide clinical expertise to support investigative and analytical initiatives
CCS (Certified Coding Specialist) or CIC (Certified Inpatient Coder) certification or the ability to obtain within six months of hire
Minimum of 3 years of MS-DRG / APR-DRG coding experience in a hospital setting with expertise in ICD-10 coding and DRG reimbursement methodologies
Advanced knowledge of : ICD-10-CM coding principles, including principal diagnosis selection, CCs / MCCs, and SOI / ROM considerations. ICD-10-PCS coding principles, including root operations, body systems, devices, and qualifiers
A reliable high-speed internet connection (the faster the better!)
Ability to pass a background check and drug test
Private, quiet, and distraction-free workspace in a room with a closed-door
Highly Preferred
Large corporation experience
Health plan / managed care / healthcare industry experience
Experience with prior DRG concurrent and / or retrospective overpayment identification audits
Experience with readmission reviews of claims
Experience with DRG encoder tools (ex. 3M)
Experience using Microsoft Excel with the ability to create / edit spreadsheets, use sort / filter function, and perform data entry
Benefits Offered :
Weekly pay
Medical, dental, and vision coverage
Voluntary Life and AD&D coverage
Paid Training
Opportunity for advancement upon performance and availability
Keep a pulse on the job market with advanced job matching technology.
If your compensation planning software is too rigid to deploy winning incentive strategies, it’s time to find an adaptable solution.
Compensation Planning
Enhance your organization's compensation strategy with salary data sets that HR and team managers can use to pay your staff right.
Surveys & Data Sets
What is the career path for a Remote Inpatient DRG Coding Auditor RN?
Sign up to receive alerts about other jobs on the Remote Inpatient DRG Coding Auditor RN career path by checking the boxes next to the positions that interest you.
