DRG & Coding Quality Specialist

R1; United States; Remote; USD 39,000 - 55,000; Full time

Benefits offered by this job

Competitive benefits package

Job summary

R1 is seeking a Coding Integrity Specialist to work with the Coding Integrity Manager and Director of Coding Operations to establish open communication on coding quality concerns. You will lead and perform coding quality reviews, analyze large datasets, and multi-task across reviews to ensure accurate reimbursement.

Work with CDI teams to resolve documentation inconsistencies, ensure KPIs, SLAs, RIS, and DNFB are met, and participate in pre-bill and post-bill reviews, escalating for write-offs

Qualifications

• Bachelor's or associate’s degree in HIM related fields or CCS credential is required.
• Minimum 5 years of inpatient coding.

Responsibilities

• Conduct complex coding quality reviews and ensure accurate DRG and reimbursement.
• Collaborate with CDI team to resolve documentation inconsistencies and variances.
• Allocate education and feedback to coders and coding managers for corrections.

Skills

Inpatient coding experience

CCS credential or HIM degree

Education

Bachelor's or Associate’s degree in HIM

Job description

R1 is seeking a Coding Integrity Specialist to work with the Coding Integrity Manager and Director of Coding Operations to establish open communication on coding quality concerns. You will lead and perform coding quality reviews, analyze large datasets, and multi-task across reviews to ensure accurate reimbursement.

Work with CDI teams to resolve documentation inconsistencies, ensure KPIs, SLAs, RIS, and DNFB are met, and participate in pre-bill and post-bill reviews, escalating for write-offs