Remote DRG Coding & Clinical Validation Analyst I–III

Lifetime Benefit Solutions, Inc.; Buffalo (NY); Hybrid; USD 65,346 - 117,622; Full time

Benefits offered by this job

Group health insurance

Retirement plan

Paid time off

Job summary

Lifetime Benefit Solutions, Inc. is seeking a Payment Integrity DRG Coding & Clinical Validation Analyst for detailed review of medical records and validation of coding accuracy. Responsibilities include ensuring compliance with coding guidelines and providing training to new hires.

The ideal candidate should have a strong background in ICD-10 coding and experience in claims auditing. Remote work may be available depending on the role.

Qualifications

• Three years’ experience in claims auditing, quality assurance, or recovery auditing.
• Understands MS/APR DRG coding and medical necessity criteria.
• Intermediate knowledge of PC software and auditing tools.

Responsibilities

• Review medical records for coding and DRG assignment accuracy.
• Analyze inpatient claims and ensure compliance with coding guidelines.
• Provide training and guidance to team members.

Skills

ICD-10 coding expertise

Analytical skills

Problem-solving skills

Knowledge of medical claims processing

Education

Associate or bachelor’s degree in health information management or nursing

Certification like RHIA, RHIT, CCS, or CIC

Tools

Claims processing systems

Auditing tools

Job description

Lifetime Benefit Solutions, Inc. is seeking a Payment Integrity DRG Coding & Clinical Validation Analyst for detailed review of medical records and validation of coding accuracy. Responsibilities include ensuring compliance with coding guidelines and providing training to new hires.

The ideal candidate should have a strong background in ICD-10 coding and experience in claims auditing. Remote work may be available depending on the role.