Team Lead, DRG Auditing

Responsibilities: Lead and mentor a team of auditors to ensure the accuracy of claims and maximize overpayment identification. Conduct comprehensive coding reviews and craft well-supported audit findings based on industry guidelines and regulations.

Requirements: Requires over 8 years of MS-DRG and ARP-DRG review experience and 2-3 years of supervisory experience in a remote environment. A CCS credential is highly preferred, along with advanced expertise in ICD-10-CM/PCS coding.

Key skills: DRG Auditing, ICD-10-CM/PCS Coding, Team Leadership, Payment Integrity, Clinical Validation, MS-DRG Review, ARP-DRG Review, Audit Findings Documentation, Compliance Management, HIPAA Compliance, Analytical Skills, Professional Judgment, Workload Management, Cross-functional Collaboration, Quality Review, Remote Team Management

Keywords: DRG, Payment Integrity, CCS, RHIA, RHIT, ICD-10-CM, ICD-10-PCS, AHA Coding Clinic, CMS NCDs, CMS LCDs, MS-DRG, ARP-DRG, HIPAA, Clinical Intelligence, Audit Findings, Upcoding, Case Rate, Per Diem, Healthcare Economics, Payer-Provider Collaboration, Mac