Job Description
Job Description
Insight Global is seeking experienced DRG Auditors to join a remote healthcare organization. The DRG Revenue Integrity Auditor will perform Diagnostic Related Group (DRG) validation and quality audits on inpatient charts to ensure accurate coding and compliance with federal regulations. This is a remote opportunity and the salary for this role is 95-115k based on the candidates years of experience.
Key Responsibilities:
Conduct thorough chart reviews to validate that assigned codes accurately reflect the patient’s clinical picture.
Utilize ICD-10-CM and ICD-10-PCS coding systems to ensure proper code sequencing and accuracy.
Validate Present on Admission (POA) indicators, Severity of Illness (SOI), Risk of Mortality (ROM), Hierarchical Condition Category (HCC) capture, Case Mix Index (CMI), and other coding factors.
Apply current clinical criteria including MCG, InterQual, payer clinical policy bulletins, CMS guidelines, NCDs, and LCDs.
Adher...
Insight Global is seeking experienced DRG Auditors to join a remote healthcare organization. The DRG Revenue Integrity Auditor will perform Diagnostic Related Group (DRG) validation and quality audits on inpatient charts to ensure accurate coding and compliance with federal regulations. This is a remote opportunity and the salary for this role is 95-115k based on the candidates years of experience.
Key Responsibilities:
Conduct thorough chart reviews to validate that assigned codes accurately reflect the patient’s clinical picture.
Utilize ICD-10-CM and ICD-10-PCS coding systems to ensure proper code sequencing and accuracy.
Validate Present on Admission (POA) indicators, Severity of Illness (SOI), Risk of Mortality (ROM), Hierarchical Condition Category (HCC) capture, Case Mix Index (CMI), and other coding factors.
Apply current clinical criteria including MCG, InterQual, payer clinical policy bulletins, CMS guidelines, NCDs, and LCDs.
Adher...