Review post-billed inpatient claims for DRG accuracy and reimbursement.
Analyze weekly hospital billing files to identify underpaid claims using ICD-10.
Map clinical documentation to ICD-10 codes to ensure DRG accuracy.
Identify and correct undercoding or misclassification of diagnoses and procedures.
Use Health ROI edits to detect high-value opportunities (dialysis, embolization, catheterization).
Make reimbursement recommendations for client review and approval.

🎯 Requirements

Associate's or bachelor's in health information management or related field; RHIT/RHIA encouraged.
CCS certification required.
2-3 years’ DRG validation or inpatient coding experience.
Strong ICD-10-CM/PCS, DRG reimbursement knowledge; hospital billing processes.
Proficient in reading/interpreting clinical documentation across departments.
Post-bill coding experience; DRG software; MS Office (Word, Excel, Outlook).

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