Remote DRG Validation & Reimbursement Manager

Mount Sinai; United States; Remote; USD 80,000 - 100,000; Full time

Job summary

A leading health system is seeking a Clinical Reimbursement Manager to ensure coding accuracy and compliance. This role involves performing quality reviews of medical records, validating assigned ICD-10 codes, and collaborating with coding staff to develop training and policies. The ideal candidate has a strong background in anatomy and a minimum of 3 years in acute care coding. This remote position offers an opportunity to contribute to innovative patient care while fostering an inclusive working environment.

Qualifications

• Strong background in anatomy, physiology, and pharmacology.
• Minimum of 3 to 5 years of experience coding in an acute care hospital.
• Excellent current knowledge of MS-DRGs and APR-DRGs.

Responsibilities

• Performs focused reviews on ICD-10-CM/PCS coded records for accuracy.
• Validates DRG assignments flagged pre-billing.
• Initiates MD query to clarify documentation.

Skills

ICD-10-CM coding

ICD-10-PCS coding

MS-DRGs knowledge

Electronic health records

Microsoft Office Suite

Education

Strong background in anatomy and physiology

3-5 years of experience coding in an acute care hospital

Job description

A leading health system is seeking a Clinical Reimbursement Manager to ensure coding accuracy and compliance. This role involves performing quality reviews of medical records, validating assigned ICD-10 codes, and collaborating with coding staff to develop training and policies. The ideal candidate has a strong background in anatomy and a minimum of 3 years in acute care coding. This remote position offers an opportunity to contribute to innovative patient care while fostering an inclusive working environment.