Job Summary
Veuu is seeking an Inpatient & DRG Validation Auditor. This candidate will work with the Veuu’s VP Healthcare Coding Intelligence / Auditing team. This person should have an extensive background in facility-based nursing, clinical documentation, and inpatient coding and a high understanding of reimbursement guidelines, specifically an account of the MS-DRG, AP-DRG, and APR-DRG payment systems. This position is responsible for auditing inpatient medical records and generating high-quality recoverable claims for the benefit of our client and their clients. They are responsible for performing clinical reviews of medical records and other documentation to evaluate coding and DRG assignment accuracy issues.
Essential Responsibilities
- Audit inpatient medical records and generating high-quality recoverable claims for the benefit of our clients and their clients.
- Perform clinical reviews of medical records and other documentation to evaluate coding and DRG assignment accuracy issues.
- Integrate medical chart coding principles, clinical guidelines, and objectivity in performing medical audit activities.
- Substantiate conclusions, draw on advanced ICD-10 coding expertise, clinical guidelines, and industry knowledge.
- Perform work independently.
- Utilize a proprietary auditing systems with a high level of proficiency to make audit determinations and generate audit letters
- Maintain production goals set by the audit operations management team
- Achieve the expected level of accuracy and quality set by the audit for the auditing concept for valid claim identification and documentation (letter writing)
- Suggest and develop high-quality, high-value concepts and or process improvement, tools, etc
Qualifications/Requirements
- Certified Coding Specialist (CCS) certification from the American Health Information Management Association (AHIMA)
- 7 years of auditing experience
- 3-5 years of MS-DRG auditing/validating
- 5 years of acute care inpatient coding experience
- Associate degree or higher in Health Information
- Bachelor's degree preferred
- Interpersonal skills
- Communication skills
- Attention to detail
Additional Information
Veuu offers a great work environment, professional development, challenging careers, and competitive compensation. Veuu is an Equal Opportunity Employer. Employment decisions are made without regard to race, color, religion, national or ethnic origin, sex, sexual orientation, gender identity or expression, age, disability, protected veteran status or other characteristics protected by law.
Veuu will only employ those who are legally authorized to work in the United States for this opening. Any offer of employment is conditioned upon the successful completion of a drug screen (as applicable).