Inpatient DRG Coding Auditor
GeBBS Healthcare Solutions, an industry leader in Health Information Management (HIM) and Revenue Cycle Management (RCM) solutions, is seeking highly-motivated individuals with a passion for excellence & collaboration, for careers in the healthcare industry.
Job Title: Inpatient DRG Coding Auditor
GeBBS Healthcare Solutions is actively recruiting for the role of an Inpatient DRG Coding Auditor. The Inpatient DRG Coding Auditor is a remote role and will begin as soon as qualified candidates are identified.
- Objectively and accurately conduct coding reviews on medical records for assigned client audit contract while meeting compliance, productivity and quality expectations
- Appropriately refer reviews for clinical validation.
- Enter and update all contract and/or review findings a supporting documentation into the audit processing system.
- Write logic/parameters for system edits to detect incorrect coding over payments, aberrant and abusive coding patterns.
- Proof of concept development and data analysis of reports for potential edit development.
- Monitor CMS and major payer coding and reimbursement policies.
- Assist in identifying new issues for audit, perform research to validate new issues, and provide new rules, regulations and applicable Medicare or program language and explanation.
- Maintain a current knowledge of all Medicare and Commercial regulations, policies and procedures.
- Certification as a CPC, CPC-H, CPC-P, RHIA, RHIT, CCS, or CCS-P
- 3+ years of DRG coding for hospital, physician’s office or other acute facility setting
- 2+ years of direct experience in medical chart review for all provider/claim types for inpatient
- Prior auditing experience desirable in either a provider or payer environment
- Previous payer experience in a claim processing, edit development, and/or coding and reimbursement policy a plus.
- Proficient in the use of MCS 1500/UB 04 forms
- Thorough working knowledge of CPT/HCPCs/ICD-9/ICD-10, MS-DRG coding
- Working knowledge of encoder
- Proven ability to review, analyze, and research coding issues
- Reimbursement policy and/or claims software analyst experience
- Familiarity with interpreting electronic medical records (EHR)
- Typing skills, comfortable navigating and using desktop technology, as well as working knowledge of MS Office applications (Outlook, Word, Excel).
Why Work at GeBBS?
GeBBS delivers a people-oriented, equal opportunity culture that supports a friendly work environment, innovative ideas, and a benefits-rich employee package.
- Paid Time Off (PTO) at your Full Pay Rate!
- Medical, Dental, Vision and Life Insurance
- 401K Eligibility
- GeBBS Computer System supplied!
- Full IT help available 24/7!
We provide strategic solutions to an expanding customer base of healthcare providers, and medical billing companies. With a current staff of over 4,000 professionals, GeBBS is a 7-time Inc. 5000 honoree as one of the nation’s fastest growing companies.
“People are our greatest asset” is much more than just an expression to GeBBS. We make every effort to foster an environment where our teams can find an ideal balance between work and fun. Employees at GeBBS believe in being client-centric, open and ethical, innovative, and outcome-driven.
GeBBS is an equal opportunity employer and believes in creating a supportive and diverse workplace. We want to have the best available people in every job. Therefore, the Company does not discriminate, and does not permit its employees to discriminate.
Learn more about GeBBS Healthcare Solutions