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DRG Coding Auditor
2 months ago
At Plutus Health Inc., we are seeking a highly skilled DRG Coding Auditor to join our team. As a key member of our Revenue Cycle Management (RCM) services, you will play a crucial role in ensuring the accuracy and compliance of our clients' medical records.
Key Responsibilities:
- Audit and Validate Medical Records: Review patient charts and coding data to ensure accurate assignment of DRG codes, verify documented diagnoses and procedures, and identify discrepancies between documented information and coded data.
- Compliance and Quality Assurance: Ensure adherence to coding standards and regulations set by CMS and other regulatory bodies, monitor and evaluate coding practices for compliance with internal policies and external regulations.
- Error Identification and Resolution: Detect and report coding errors, discrepancies, and potential fraud, work with coding staff and healthcare providers to resolve identified issues.
- Feedback and Training: Provide constructive feedback and recommendations for improving coding accuracy, conduct training sessions and workshops to enhance the skills of coding staff.
- Stay Current with Coding Guidelines: Keep abreast of changes in coding practices, DRG classifications, and healthcare regulations, update internal practices and training materials to reflect new guidelines and standards.
Requirements:
- Education: Bachelor's degree in Health Information Management, Medical Coding, or a related field. Equivalent experience may be considered.
- Certifications: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or other relevant certifications preferred.
- Experience: Minimum of 3-5 years of experience in medical coding, with at least 2 years in DRG coding and auditing.
- Knowledge: In-depth knowledge of DRG coding systems, medical terminology, and healthcare regulations.
What We Offer:
As a DRG Coding Auditor at Plutus Health Inc., you will have the opportunity to work with a leading provider of RCM services, contribute to the improvement of our clients' financial performance, and develop your skills in a dynamic and supportive environment.
