Inpatient Medical Coding Auditor
Core
Reviews inpatient hospital claims for proper reimbursement, handles provider disputes, and ensures correct claims payment and appropriate DRG assignments.
Role type
Senior IC medical coding auditor
Builds
Accurate provider contract payments and correct claims payment in payer systems
Domain
Health insurance / Medical billing
Required skills
MS-DRG coding/auditing, claims interpretation, inpatient coding reviews/audits, Microsoft Office (Word, PowerPoint, Excel), data analysis
Preferred skills
APR DRG coding/auditing, Financial Recovery, fast-paced metric-driven operational settings
Technologies
ICD-10-CM, CPT, DRG, Microsoft Office
Responsibilities
Extract clinical information from medical records and assign procedural terminology and medical codes; Analyze and manipulate databases to increase accuracy of provider contract payments; Respond to or clarify internal requests for medical information; Handle provider disputes in a metrics-driven environment
Seniority
Senior, experienced IC
