Inpatient DRG Validator and Coding Analyst

Sarasota Memorial Hospital; Indianapolis (IN); On-site; USD 60,000 - 80,000; Full time

Job summary

Sarasota Memorial Hospital is seeking an experienced Inpatient DRG Validator & Coding Analyst to support the Revenue Integrity Service Line. The role involves reviewing inpatient coding and ensuring compliance for accurate reimbursement in hospital inpatient services.

Candidates must have at least 3 years of experience, possess a CCS credential, and demonstrate a strong understanding of regulatory compliance and coding standards. Knowledge of EHR applications and DRGs is essential for success in this position.

Qualifications

• Minimum 3 years of experience with Coding IP Claims.
• CCS credential is required.
• Experience with Medicare and Medicaid DRGs is essential.
• Strong coding knowledge and understanding of coding rules.

Responsibilities

• Review and analyze medical records for accurate coding.
• Ensure accuracy and completeness of inpatient coding.
• Maintain coding credentials and stay updated on standards.
• Consult with client organizations for optimization strategies.

Skills

ICD-10-CM coding

ICD-10-PCS coding

Coding IP Claims

EHR applications

Regulatory compliance

DRG knowledge

Education

CCS (Certified Coding Specialist)

RHIA or RHIT (preferred)

Tools

Cerner

EPIC

Meditech

MS Office

Job description

At Kodiak Solutions, we’re dedicated to transforming the healthcare industry through cutting‑edge, technology‑driven solutions. We specialize in healthcare finance, unclaimed property, risk management, and revenue cycle management, helping healthcare organizations streamline complex financial operations. Our mission is to simplify and optimize processes, so healthcare providers can focus on delivering excellent patient care.

TheInpatient DRG Validator & Coding Analyst will work closely with theSupervisor/ Manager of Revenue Integrity Services to achieve the Revenue Integrity Service Line’s goals and objectives and Company‑wide goals and initiatives. TheInpatient DRG Validator & Coding Analyst will be responsible for supporting the Kodiak Service Line by providing inpatient coding reviews, as well as supporting other Kodiak Service Lines.

Essential Duties and Responsibilities

Include the following. Other duties may be assigned.

• Ability to read, decipher and analyze all aspects of medical record documentation for accurate coding.
• Responsible for reviewing inpatient coding (ICD-10-CM and ICD-10-PCS codes) to ensure accuracy and completeness of records coded by the coding staff for multiple clients.
• Validate the ICD-10‑CM and PCS codes, principal and secondary diagnoses
• Assignment appropriateness to ensure consistency and efficiency and to optimize DRG reimbursement and facilitate data quality in hospital inpatient services.
• Review physician documentation for specificity, completeness, and quality to support coding accuracy, and to identify physician query opportunities to improve the documentation.
• Maintains current knowledge of regulatory agencies standards, i.e., CMS, OIG, AHA, Coding Clinics etc.
• Maintain required coding credential(s)
• Seeks opportunities for individual growth and development, including attending various meetings, conferences, and courses, as required,
• Responsible for meeting departmental productivity and quality expectations.
• Consult with client organizations and their department heads at the direction of the service line director.
• Collaborate with other service line team members to meet client demands and to develop strategies for service line growth and operational improvement.

Required Qualifications

• A minimum, 3+ years’ experience with Coding IP Claims
• CCS (Certified Coding Specialist) credential required
• Experience with Medicare and Medicaid DRGs.
• Experience with DRG Validator.
• Experience with OP coding a plus.
• Strong coding knowledge and follow the official coding rules, guidelines, and conventions to validate coded data and ensure high quality and compliance with regulatory requirements.
• Demonstrates competency in the use of computer applications in the EHR (i.e., Cerner, EPIC, Meditech, etc.) and knowledge in DRG grouping software.
• Computer proficiency as related to MS Office and in-house proprietary software.
• Demonstrates knowledge in hospital/healthcare settings such as revenue cycle, coding, and reimbursement.
• Knowledge of ICD-10-CM/PCS required
• ICD-10-CM/PCS AHIMA Approved Trainer experience highly desired.
• RHIA or RHIT a plus, CCS credential required.