Job title : Medical Review Auditor – DRG CodingLocation : 100% RemoteDuration : Contract to hire
Position Overview
We are seeking a Medical Review Auditor to join the healthcare team, primarily responsible for conducting DRG reviews and inpatient medical coding audits. Due to an increase in DRG review volume, the team is expanding its existing medical review function.
The ideal candidate should have inpatient coding experience or a relevant coding/health information credential, with inpatient experience strongly preferred.
Key Responsibilities- Perform DRG reviews and audits of inpatient medical records.
- Validate ICD-10-CM/PCS coding accuracy and DRG assignments.
- Review clinical documentation to identify coding discrepancies.
- Ensure compliance with coding guidelines and reimbursement requirements.
- Document audit findings and recommend necessary corrections.
Must-Have Skills- At least one of the following certifications:
- RHIT – Registered Health Information Technician
- RHIA – Registered Health Information Administrator
- CIC – Certified Inpatient Coder
- CPMA – Certified Professional Medical Auditor
- CPC – Certified Professional Coder
- Inpatient (IP) medical coding experience.
- Knowledge of ICD-10-CM/PCS coding.
- Understanding of DRG reviews and medical record audits.
Nice-to-Have Skills- Previous DRG auditing or validation experience.
- Knowledge of MS-DRG assignment.
- Experience identifying coding discrepancies and documentation gaps.
- Hospital coding, medical review, or health insurance experience.
- Knowledge of Medicare reimbursement guidelines.