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DRG Integrity Specialist
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- As a valued member of the DRG Review Team, the DRG Integrity Specialist performs a secondary level review of medical records and code assignment using knowledge of Accuity technology and client systems with a physician in accordance with federal coding regulations and guidelines as well as client specific coding guidelines to ensure accurate DRG assignment.
- Review pre-bill cases simultaneously with a physician during each work shift excluding breaks and meetings to analyze and validate diagnosis and procedure codes for inpatient services via coding compliance and clinical knowledge to support accurate DRG assignment
- Researches, analyzes, and responds to inquiries regarding compliance, inappropriate coding, and client denials
- Experience and knowledge in DRG reimbursement (i.e., MS-DRG, APR-DRG)
- Coding credential required from AHIMA/AAPC (RHIA, RHIT, CCS and/or CPC, or CIC)
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