Inpatient DRG Validation Auditor I

R1 RCM Holdco Inc.; Illinois; Hybrid; USD 48,000 - 81,000; Full time

Benefits offered by this job

Annual bonus

Competitive benefits

Job summary

R1 RCM Inc. is seeking a DRG Validation Auditor I to audit inpatient cases for DRG validation and documentation improvement. You will review accounts in proprietary software and client EMR systems to validate the accounts.

Daily tasks include reviewing records for DRG validation, providing detailed rationale with evidence, and citing ICD-10 guidelines. Candidates should have AHIMA credentials (RHIA, RHIT, CCS) and 3+ years of acute inpatient auditing experience with Epic, Cerner, or Meditech.

Qualifications

• Current AHIMA credentials RHIA, RHIT, and/or CCS are required.
• 3+ years of ICD-10 coding and DRG reimbursement experience, with recent acute inpatient auditing experience.
• Experience with multiple EMR systems such as Epic, Cerner, and Meditech.

Responsibilities

• Review inpatient medical records for validation of DRG assignment.
• Provide detailed rationale and supporting evidence for the recommendation and findings.
• Utilize industry-recognized references to support review findings (ICD-10 Guidelines, AHIMA Standards, AHIMA Practice Briefs, AHA Coding Clinics).

Skills

ICD-10 coding

DRG reimbursement

Education

RHIA

RHIT

CCS

Tools

Epic

Cerner

Meditech

Job description

R1 RCM Inc. is seeking a DRG Validation Auditor I to audit inpatient cases for DRG validation and documentation improvement. You will review accounts in proprietary software and client EMR systems to validate the accounts.

Daily tasks include reviewing records for DRG validation, providing detailed rationale with evidence, and citing ICD-10 guidelines. Candidates should have AHIMA credentials (RHIA, RHIT, CCS) and 3+ years of acute inpatient auditing experience with Epic, Cerner, or Meditech.