Remote Inpatient DRG Auditor & Coding Specialist

Zelis; Saint Petersburg (FL); Hybrid; USD 79,000 - 99,750; Full time

Benefits offered by this job

401k plan with employer match

Flexible paid time off

Health benefits including medical, dental, and vision

Job summary

A healthcare technology company seeks a skilled professional to conduct comprehensive inpatient DRG reviews and validation within the Price Optimization division. Candidates must have an RN or LVN degree and an inpatient coding certification. This role requires attention to detail and experience with Health Insurance and Medicare guidelines. The position includes a competitive salary range and offers a hybrid work culture, allowing for flexibility in work location while maintaining a focus on teamwork and productivity.

Qualifications

• 1-3 years reviewing or auditing ICD-10 CM, MS-DRG and APPR-DRG claims preferred.
• Experience with Health Insurance and Medicare guidelines.
• Strong organizational skills and clinical skills.

Responsibilities

• Conduct comprehensive inpatient DRG reviews and validation.
• Perform readmission reviews and document findings.
• Manage assigned claims and meet productivity standards.

Skills

Inpatient DRG validation

ICD-10 coding

Clinical analysis

Communication skills

Attention to detail

Education

RN or LVN required

Inpatient Coding Certification (CCS, CIC)

Job description

A healthcare technology company seeks a skilled professional to conduct comprehensive inpatient DRG reviews and validation within the Price Optimization division. Candidates must have an RN or LVN degree and an inpatient coding certification. This role requires attention to detail and experience with Health Insurance and Medicare guidelines. The position includes a competitive salary range and offers a hybrid work culture, allowing for flexibility in work location while maintaining a focus on teamwork and productivity.