Remote DRG Coding & Clinical Validation Analyst I–III

Lifetime Benefit Solutions, Inc.; City of Rochester (NY); On-site; USD 65,346 - 117,622; Full time

Benefits offered by this job

Group health insurance

Retirement plan

Wellness program

Paid time off

Paid holidays

Job summary

Lifetime Benefit Solutions, Inc. seeks a Payment Integrity DRG Coding & Clinical Validation Analyst in Rochester, NY. The role requires validating coding and DRG assignment accuracy through rigorous analysis of medical records and adherence to compliance guidelines.

Ideal candidates should have a degree in health information management and extensive experience in claims auditing related to MS/APR DRG coding. The position offers a competitive salary and potential for remote work.

Qualifications

• Experience in claims auditing or recovery auditing of MS/APR DRG coding is required.
• Knowledge of medical claims billing/payment systems is essential.
• Must maintain coding certification as a condition of employment.

Responsibilities

• Review medical records to validate coding and DRG assignment accuracy.
• Analyze and audit acute inpatient claims for coding accuracy.
• Ensure compliance with coding guidelines and regulations.

Skills

ICD-10 coding expertise

Analytical skills

Problem-solving skills

Knowledge of billing systems

Education

Associate or bachelor’s degree in health information management

Coding certification (RHIA or RHIT, CCS, or CIC)

Tools

Auditing tools

Claims processing systems

PC software

Job description

Lifetime Benefit Solutions, Inc. seeks a Payment Integrity DRG Coding & Clinical Validation Analyst in Rochester, NY. The role requires validating coding and DRG assignment accuracy through rigorous analysis of medical records and adherence to compliance guidelines.

Ideal candidates should have a degree in health information management and extensive experience in claims auditing related to MS/APR DRG coding. The position offers a competitive salary and potential for remote work.