• Job Description

  Req#: RQ4018908
  Employer Industry: Healthcare Services
  
  Why consider this job opportunity:
  - This is a remote role that offers flexibility to work from most U.S. states.
  - Opportunity for career advancement and growth within the organization.
  - Engage in a supportive and collaborative work environment with a focus on quality.
  - Competitive pay and comprehensive benefits package.
  - Chance to make a significant impact on patient care and reimbursement accuracy.
  - Work standard business hours, Monday through Friday.
  
  What to Expect (Job Responsibilities):
  - Perform DRG validation and quality audits on claims, ensuring compliance with medical and reimbursement policies.
  - Utilize expert clinical knowledge to assign ICD-10-CM/PCS codes and ensure accurate coding practices.
  - Review and analyze facility and professional claims to support medical policies and guidelines.
  - Identify billing trends and provide analytical data to enhance audit methodologies.
  - Maintain daily case review assignments with a strong emphasis on quality in a high-volume production environment.
  
  What is Required (Qualifications):
  - Associate’s degree required or equivalent combination of training and experience, plus 3-5 years of related experience; Bachelor’s degree preferred.
  - Certified Inpatient Coder (CIC), Certified Professional Coder (CPC), CPC-H (hospital), or CCS (Certified Coding Specialist) certification.
  - Minimum of 5 years of experience in a DRG validation role, including claims auditing and recovery auditing.
  - Thorough knowledge of ICD-10, ICD-10-PCS, MS-DRG, AP-DRG, APR-DRG, CPT, HCPCS, and Revenue Billing Codes.
  - Superior skills in Microsoft Suite and Excel are required.
  
  How to Stand Out (Preferred Qualifications):
  - Nursing license preferred.
  - Strong project management skills and familiarity with the regulatory environment for financial services.
  - Ability to communicate complex topics effectively in various forums.
  - Strong interpersonal skills and the ability to influence others at all levels of an organization.
  - High emotional intelligence and a strong work ethic focused on quality.
  
  #HealthcareServices #RemoteWork #CareerOpportunity #CodingExpertise #QualityAudit
  
  We prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately. We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.

• About the company

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