Job Posting for DRG Reviewer – Level 1 at MedReview Inc.

Position Summary

At MedReview, our mission is to bring accuracy, accountability, and clinical excellence to healthcare. As such, we are a leading authority in payment integrity solutions including DRG Validation, Cost Outlier and Readmission reviews.

Under the direction of the Coding Department leaders, the Level 1 DRG Reviewer will conduct initial reviews of the claims within the internal CORE application.

Responsibilities

Analyze and review inpatient claims following the Official Coding and Reporting Guidelines to validate the reported ICD-10-CM/PCS codes to ensure proper DRG assignment for accurate billing
Demonstrates the ability to perform a comprehensive initial review as outlined in the standard operating procedures and departmental guides
Collaborates with physician reviewers, as needed
Ability to prioritize and organize workload and complete tasks independently
Required attendance of all departmental team meetings and/or training
Work on other duties or tasks, as necessary

Performance Expectations

Report productivity daily utilizing department productivity report
Meet/exceed productivity expectations as outlined in the department productivity policy
Maintains 95% accuracy in claim reviews
Complies with organization policy and procedures

Qualifications

Coding Certification required (at least one of the following is required and must be maintained as a condition of employment)

Registered Health Information Administrator (RHIA)
Registered Heath Information Technician (RHIT)
Certified Coding Specialist (CCS)
Certified Inpatient Coder (CIC)
Candidates with a Registered Heath Information Technician (RHIT)
Certified Clinical Documentation Specialist (CCDS), Certified Documentation Improvement Practitioner (CDIP) or Certified Professional Coder (CPC) will be considered but will need to obtain an inpatient coding certification (CCS or CIC) within 12 months of hire
College level courses in medical terminology, anatomy, pathophysiology, pharmacology, and medical coding courses
At least 1 year of experience in MS-DRG and APR-DRG coding experience through acute care inpatient coding, auditing, and/or payment integrity DRG Validation
Adherence to the Official Coding and Reporting guidelines, AHA Coding Clinic determinations, and CMS and other regulatory compliance guidelines and mandates
Requires working knowledge of applicable industry-based standards
Proficiency in Outlook, Word, Excel, and other applications
Excellent written and verbal communication skills
Maintain professional credentialed status with approved continuing education programs
Ability to work independently and can multi-task or transition to different tasks easily

Healthcare that fits your needs - We offer excellent medical, dental, and vision plan options that provide coverage to employees and dependents
401(k) with Employer Match - Join the team and we will invest in your future
Generous Paid Time Off - Accrued PTO starting day one, plus additional days off when you’re not feeling well, to observe holidays
Wellness - We care about your well-being. From Commuter Benefits to FSAs we’ve got you covered
Learning & Development - Through continued education/mentorship on the job and our investment in LinkedIn Learning, we’re focused on your growth as a working professional

Remote Work Requirements

High speed internet (100 Mbps per person recommended) with secured WIFI
A dedicated workspace with minimal interruptions to protect PHI and HIPAA information
Must be able to sit and use a computer keyboard for extended periods of time

Salary: starting at $85k

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DRG Reviewer – Level 1

Job Posting for DRG Reviewer – Level 1 at MedReview Inc.

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