FREE ACCESS
5,000–10,000 jobs/day
See all jobs on Scoutfield
Search thousands of fresh jobs every day.
Discover
- Fresh listings
- Fast filters
- No subscription required
Create a free account and start exploring right away.
DRG Validation Coding Auditor
Ensemble Health Partners. Perform documentation and coding audits for acute inpatient services .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in coding audits, compliance, and documentation for acute inpatient services, with a strong focus on DRG coding, reimbursement optimization, and adherence to coding guidelines. Proficient in analyzing claims and collaborating with clinical documentation improvement specialists to enhance coding accuracy and quality.
Highest-signal resume keywords
DRG Coding Audit ExperienceProficiency in EMRs and EncodersCPC, CCS, RHIA, or RHIT CertificationKnowledge of HIPAA RegulationsAbility to Communicate Effectively in English
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Coding AuditsDRG Assignment VerificationClinical Documentation AnalysisReimbursement OptimizationCoding Error IdentificationCompliance Issue AssessmentMedical Record VerificationClaims AnalysisDocumentation RecommendationsProcess Improvement
Soft Skills
Above-Average Written CommunicationAbove-Average Verbal CommunicationOrganizational SkillsTimelinessOpenness to Innovation
Tools & Technologies
Proprietary SystemsEncoder ToolsMicrosoft Office Suite
Certifications & Qualifications
CPCCCSRHIARHIT
Industry Keywords
Acute Inpatient ServicesCoding GuidelinesComplianceQuality GoalsPatient SeverityMedical/Surgical TerminologyAudit LeadersClient Turnaround ExpectationsEducation OpportunitiesReimbursement Policies
About the role
Key responsibilities & impact- Perform documentation and coding audits for acute inpatient services
- Identify coding errors, compliance issues, educational opportunities, and quality concerns
- Optimize reimbursement by ensuring diagnosis and procedure codes and supporting documentation accurately support services rendered
- Conduct DRG coding and clinical reviews to verify coding, DRG assignment, and clinical indicators
- Assess whether clinical documentation supports coded diagnoses and procedures
- Verify medical records justify assigned DRGs and reflect patient severity and resources used
- Collaborate with CDI specialists on documentation and query opportunities
- Maintain productivity and quality goals set by audit leaders
- Write clear recommendations and provide feedback and education to acute inpatient coders
- Complete audits accurately and timely according to client turnaround and quality expectations
- Maintain current certifications, CEUs, and knowledge of coding guidelines
- Complete internal application, compliance, and mandatory education
- Use proprietary systems and encoder tools to make audit determinations and generate recommendations
- Analyze claims using a 30-day lookback to identify overpayments, underpayments, and discrepancies
- Monitor changes in acute inpatient coding regulations and reimbursement policies
- Identify additional recovery or compliance opportunities and assist with process improvement
Requirements
What you’ll need- 5+ years of coding experience
- 3+ years of facility coding audit experience, such as DRG and APC Validation
- Proficiency in multiple EMRs, encoders, and the Microsoft Office suite
- Educated in HIPAA regulations and able to maintain strict confidentiality of patient and client information
- Ability to achieve quality and productivity standards
- Ability to organize and complete work in a timely manner
- Ability to read, write, and effectively communicate in English
- Ability to understand medical/surgical terminology
- Above-average written and verbal communication skills
- Openness to innovation, including AI
- Willingness and ability to travel to and work onsite at client, temporary, or corporate office locations as business needs require
- Bachelor’s degree or equivalent experience
- Must maintain at least one current professional certification: CPC, CCS, RHIA, or RHIT
- CCS preferred
Benefits
Comp & perks- Bonus Incentives
- Paid Certifications
- Tuition Reimbursement
- Comprehensive Benefits, including healthcare, time off, retirement, and well-being programs
- Career Advancement
- Professional development opportunities
- Professional certification relevant to the associate’s field
- Quarterly and annual incentive programs
- Work-life flexibility
- Reasonable accommodations for qualified individuals with disabilities