DRG Validation & Coding Manager

Mount Sinai Health System; New York (NY); Remote; USD 79,720 - 123,188; Full time

Job summary

A leading healthcare organization in New York seeks a Coding Reviewer for DRG validation. The role involves ensuring the accuracy of diagnostic codes and compliance with healthcare regulations. Candidates must have a strong background in anatomy and coding, with 3-5 years of experience in an acute care setting. Responsibilities include reviewing medical records, initiating queries to ensure accurate documentation, and collaborating with healthcare teams. Committed to fostering an inclusive workplace culture.

Qualifications

• Strong background in anatomy, physiology, and pharmacology.
• Minimum of 3-5 years in acute care hospital coding.
• Excellent knowledge of MS-DRGs and APR-DRGs.
• Familiarity with electronic health records and data systems.

Responsibilities

• Perform detailed reviews of coded medical records.
• Validate accuracy and appropriateness of DRG assignments.
• Initiate queries to clarify documentation with physicians.
• Provide feedback and document coding changes effectively.
• Investigate unbilled accounts and resolve discrepancies.

Skills

Anatomy knowledge

ICD-10-CM and ICD-10-PCS coding experience

Experience in acute care hospital coding

Knowledge of MS-DRGs and APR-DRGs

Good working knowledge of electronic health records

Education

Relevant coding certification

Job description

A leading healthcare organization in New York seeks a Coding Reviewer for DRG validation. The role involves ensuring the accuracy of diagnostic codes and compliance with healthcare regulations. Candidates must have a strong background in anatomy and coding, with 3-5 years of experience in an acute care setting. Responsibilities include reviewing medical records, initiating queries to ensure accurate documentation, and collaborating with healthcare teams. Committed to fostering an inclusive workplace culture.