DRG Coding Quality Analyst Position Available In Fulton, Georgia

Location:

REMOTE Salary:

$34.00 USD Hourly – $37.00

USD Hourly Description:

Our client is currently seeking to hire DRG Coding Quality Analyst on a contract to hire basis. DRG Validation RN Auditor (US – Telecommute)

Location:

Remote, United States Employment Type:

Full-time Rate:

$37.00 per hour About the Role As a DRG Validation RN Auditor , you will play a critical role in auditing inpatient claims, ensuring the accuracy of MS-DRG and APR-DRG coding and reimbursement methodologies. Using industry-standard and proprietary tools, you will validate ICD-10 diagnosis and procedure codes, DRG assignments, and discharge statuses to identify potential overpayments. Your expertise in ICD-10 coding guidelines and AHA Coding Clinic directives will support thorough audit findings and rationales. Key Responsibilities Conduct MS-DRG and APR-DRG coding audits, focusing on accurate DRG assignment and reimbursement validation Apply expert knowledge of

ICD-10-CM/PCS

coding, sequencing, POA assignment, and discharge disposition Ensure compliance with CMS requirements, ICD-10 Official Guidelines, and AHA Coding Clinic guidance Leverage clinical expertise to validate coding accuracy and billing correctness Utilize proprietary workflow systems and encoder tools efficiently to process claims Maintain high-quality case review assignments in a matrix-driven, high-volume environment Required Qualifications Unrestricted RN (Registered Nurse) license CCS/CIC certification or ability to obtain within 6 months of hire 3+ years of MS-DRG and APR-DRG coding experience in a hospital setting Deep expertise in

ICD-10-CM/PCS

coding , including principal diagnosis selection, CC/MCC identification, and severity-of-illness (SOI) and risk-of-mortality (ROM) evaluation Preferred Qualifications Experience with DRG audits, readmission reviews, and overpayment identification Familiarity with DRG encoder tools (e.g., 3M) Proficiency in Microsoft Excel for data entry and analysis Background in managed care and healthcare claims processing Skills & Competencies Excellent written and verbal communication skills Strong analytical abilities and attention to detail Ability to work independently in a remote setting Exceptional time management and prioritization skills By providing your phone number, you consent to: (1) receive automated text messages and calls from the Judge Group, Inc. and its affiliates (collectively “Judge”) to such phone number regarding job opportunities, your job application, and for other related purposes. Message & data rates apply and message frequency may vary. Consistent with Judge’s Privacy Policy, information obtained from your consent will not be shared with third parties for marketing/promotional purposes. Reply STOP to opt out of receiving telephone calls and text messages from Judge and HELP for help.

Contact:

mbondi@judge.com This job and many more are available through The Judge Group. Find us on the web at www.judge.com