Remote Payment Integrity: DRG Coding Analyst

Univera Healthcare; Buffalo (NY); Hybrid; USD 65,346 - 117,622; Full time

Benefits offered by this job

Group health and/or dental insurance

Retirement plan

Paid time away from work

Paid holidays

Wellness program

Job summary

Univera Healthcare in Buffalo, New York is seeking a Payment Integrity DRG Coding & Clinical Validation Analyst. This role requires expertise in acute facility-based clinical documentation and an understanding of MS-DRG and APR-DRG payment systems. You will review medical records for documentation accuracy, ensuring compliance with coding standards.

This position offers a competitive salary range of $65,346 to $117,622, depending on experience and qualifications. Remote work may be possible based on individual circumstances.

Qualifications

• Three (3) years’ experience in claims auditing, quality assurance, or recovery auditing of MS/APR DRG coding.
• Intermediate knowledge of PC, software, auditing tools and claims processing systems.
• Coding Certification such as RHIA or RHIT, CCS or CIC is required.

Responsibilities

• Analyzes and audits acute inpatient claims.
• Ensures compliance with coding guidelines and CMS mandates.
• Provides training and guidance to team members.

Skills

Analytical skills

Problem-solving skills

ICD-10 coding expertise

Attention to detail

Education

Associate or bachelor’s degree in health information management (RHIA or RHIT) or Nursing Degree

Tools

DRG grouper

Claims processing systems

Auditing tools

Job description

Univera Healthcare in Buffalo, New York is seeking a Payment Integrity DRG Coding & Clinical Validation Analyst. This role requires expertise in acute facility-based clinical documentation and an understanding of MS-DRG and APR-DRG payment systems. You will review medical records for documentation accuracy, ensuring compliance with coding standards.

This position offers a competitive salary range of $65,346 to $117,622, depending on experience and qualifications. Remote work may be possible based on individual circumstances.