06 ott - Verona
ACDIS Pediatric Networking Group
Join a Team of Industry-Leading Experts and Help Shape the Future of Revenue Integrity
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Are you a passionate coding and revenue integrity professional who thrives on clinical accuracy, continuous learning, and making a meaningful impact? At CorroHealth, you’ll work alongside some of the nation’s most respected physicians, clinical leaders, coding experts, and healthcare innovators to ensure the highest standards of coding accuracy and revenue integrity for leading healthcare organizations.
As a global healthcare solutions company, we invest in our people through continued education, career advancement opportunities, mentorship from industry experts, and a flexible work environment that supports work-life balance. If you’re looking for an opportunity to elevate your expertise while partnering with exceptional clients and colleagues, we’d love to hear from you.
Sign on bonus available
What You’ll Do
The DRG Revenue Integrity Auditor (DRG-A) performs comprehensive Diagnostic Related Group (DRG)
validation and quality audits on inpatient medical records to ensure accurate representation of each patient's clinical story.
In this role, you will:
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- Perform detailed DRG validation reviews of inpatient charts.
- Ensure assigned ICD-10-CM/PCS codes accurately reflect the patient's clinical condition and treatment.
- Validate proper sequencing and accuracy of diagnoses and procedures.
- Review and assess:
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- Present on Admission (POA) indicators
- Severity of Illness (SOI)
- Risk of Mortality (ROM)
- Case Mix Index (CMI)
- Hierarchical Condition Category (HCC) capture
- Other coding and reimbursement factors
- Utilize current coding references and clinical criteria including:
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- ICD-10-CM/PCS
- CMS Guidelines
- MCG
- InterQual
- National Coverage Determinations (NCDs)
- Local Coverage Determinations (LCDs)
- Payer clinical policy guidelines
- Adhere to coding guidelin
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