MedReview Inc. helps payors identify inaccurate medical claims to save millions in overpayments.
DRG Reviewer
Location
United States
Posted
8 days ago
Salary
$85K - $90K / year
Seniority
Senior
Job Description
DRG Reviewer
MedReview Inc.
• 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. • Report productivity daily utilizing department productivity report. • Meet/exceed daily productivity expectations. • Maintains 95% accuracy in claim reviews. • Must be available to work a 7.5-hour workday during Eastern Standard Time (EST) business hours. • Comply with organization policy and procedures.
Job Requirements
- Coding Certification required (at least one of the following is required and must be maintained as a condition of employment).
- Certified Coding Specialist (CCS)
- Certified Inpatient Coder (CIC)
- Registered Heath Information Technician (RHIT)
- College level courses in medical terminology, anatomy, pathophysiology, pharmacology, and medical coding courses.
- At least 3 years’ experience in MS-DRG and APR-DRG validation in acute care inpatient coding, auditing.
- Payment integrity DRG validation is a plus.
- 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.
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.
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