DRG Inpatient Coding Validator
Remote · from United States
Core
Review inpatient claims prospectively and retrospectively to identify DRG-related coding and payment inaccuracies, including potential overpayments and upcoding.
Role type
Inpatient clinical coding validator (payment integrity)
Builds
Accurate DRG assignments and reimbursement decisions for inpatient claims
Domain
Healthcare / Medical Billing & Coding
Required skills
DRG pricing methodology, inpatient clinical coding, clinical documentation review, claims adjudication, regulatory compliance, analytical skills, Microsoft Excel
Preferred skills
Medicare or Medicare Advantage payment integrity experience
Technologies
Microsoft Excel, PowerPoint
