California Licensed DRG Audit SME
Company: VirtualVocations
Location: Eugene
Posted on: March 29, 2025
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Job Description:
A company is looking for a Senior DRG Audit Subject Matter
Expert (SME).
Key Responsibilities
Conduct comprehensive DRG validation audits of inpatient medical
records for accurate coding and compliance
Serve as an inpatient coding expert and resource for coding teams,
ensuring accuracy and adherence to standards
Develop and refine coding policies and procedures in collaboration
with the HIM team
Required Qualifications
Associates or Bachelor's degree in Nursing or Health Information
Management (RHIA or RHIT)
5+ years of experience in claims auditing, quality assurance, or
recovery auditing, preferably in a DRG/Clinical Validation Audit
setting
Coding certifications: RHIA or RHIT; CCS or CIC preferred
5-10 years of experience with ICD-9/10CM, MS-DRG, AP-DRG, and
APR-DRG
Experience developing audit selection criteria for identifying DRG
coding errors and overpayments
Keywords: VirtualVocations, Eugene , California Licensed DRG Audit SME, Accounting, Auditing , Eugene, Oregon
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