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DRG Revenue Integrity Auditor @CorroHealth Inc

[Hiring] DRG Revenue Integrity Auditor @CorroHealth Inc

Mar 27, 2025 - CorroHealth Inc is hiring a remote DRG Revenue Integrity Auditor. 💸 Salary: sign on bonus available. 📍Location: USA.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more.

Role Description

The DRG Revenue Integrity Auditor (DRG - A) performs Diagnostic Related Group (DRG) validation and quality audits on Inpatient charts. The DRG - A will:

  • Perform chart reviews to ensure that all reviewed charts capture the patient’s true clinical picture from the codes assigned by the facility’s coders in compliance with federal laws.
  • Utilize International Classification of Diseases - Clinical Modification (CM) and Procedure Coding System (PCS) Terminology to ensure accurate coding.
  • Validate proper sequencing and accuracy of ICD-10-CM/PCS codes, POA assignments, severity of illness (SOI), risk of mortality (ROM), Hierarchical Condition Category (HCC) capture CMI, and other coding factors.
  • Use the most current Clinical Criteria, MCG, InterQual, payers’ Clinical Policy Bulletins, CMS Guidelines, NCDs, and/or LCDs.
  • Adhere to all coding guidelines and CDI best practices, as endorsed by ACDIS and AHIMA, to determine correct coding that is clinically supported and compose and send queries when necessary.
  • Analyze records for potential query opportunities and appropriate code assignment along with correct code sequencing.
  • Maintain quality of reviews by ensuring the true clinical picture is captured timely.
  • Stay up to date with medical and coding guidelines, along with advancements within their field.
  • Support CorroHealth in developing accurate training materials.
  • Provide training and shadowing to new hires.
  • Assist CorroHealth with project data analysis, reporting, and feedback internally and externally to CorroHealth clients.
  • Maintain professional etiquette and ensure all PHI is appropriately stored and delivered to authorized individuals.
  • Meet or exceed production and quality metrics.
  • Attend all mandatory meetings and trainings.
  • Audit clients’ clinical documentation integrity (CDI) program to include query review, analysis of coding, and overall program accuracy.
  • Keep up with company and EMR access logins and passwords.
  • Perform all other position-related duties as delegated by management.

Qualifications

  • Five or more years working in an acute care setting or a third-party vendor as a DRG Auditor or Clinical Documentation Specialist (CDS).
  • Prior experience of working as a CDI/Coding auditor is preferred but NOT a requirement.

Requirements

  • Experience with telecommuting and electronic medical record systems required.
  • Good computer skills and familiarity with commonly used work apps, such as MS Word, MS Excel, MS Outlook, Teams, etc.
  • Strong analytical skills and ability to work with numbers using basic math skills.
  • Strong team player with the ability to work with multiple and diverse clients and projects.
  • Ability to switch between multiple clients throughout the day and week.
  • Ability to work with minimal supervision and maintain access to multiple files.

Benefits

  • Quality of life with a remote predictable, full-time schedule.
  • Exempt/Salaried positions.
  • Opportunities for career growth within the organization.
  • Medical, Dental, Vision coverage, 401K with match.
  • Long-term disability insurance, life insurance, and more.
  • Holidays and ample paid time off.
  • Allowance for CME and/or license renewal.

Physical Demands

  • Regular eye-hand coordination and manual dexterity is required to operate office equipment.
  • The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required.
  • At times, Team Members are subject to sitting for prolonged periods.
  • Infrequently, Team Members must be able to lift and move material weighing up to 20 lbs.
  • Team Members may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines.

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Before You Apply
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📍 Be aware of the location restriction for this remote position: USA
‼ Beware of scams! When applying for jobs, you should NEVER have to pay anything. Learn more.
Back to Remote jobs  >   All others
DRG Revenue Integrity Auditor @CorroHealth Inc
All others
Salary 💸 sign on bonus available
Remote Location
USA
Job Type full-time
Posted Mar 27, 2025
Apply for this position Unlock 54,564 Remote Jobs
️
📍 Be aware of the location restriction for this remote position: USA
‼ Beware of scams! When applying for jobs, you should NEVER have to pay anything. Learn more.
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