Drg Clinical Auditor 3095075 I.Html

To support the billing accuracy of complex claims, the full-time DRG Clinical Auditor will analyze inpatient and outpatient charges, document audit results, and assist in the education of coding staff while working onsite.

##### Key responsibilities

Review and analyze complex billing charges to identify abnormalities and ensure compliance with coding standards

Document audit findings and update relevant systems, while assisting management in departmental operations

Design and implement training programs for coders and clinical staff to enhance coding practices and compliance

##### Required qualifications

Minimum high school diploma with five years of experience in itemized bill review; coding certification is required

Extensive knowledge of inpatient/outpatient hospital billing, including relevant coding systems and regulations

Strong medical background to identify inappropriate charges and ensure adherence to payer reimbursement policies

Experience in auditing and health information management within a healthcare setting

Proficiency in MS Office Suite, particularly Excel and PowerPoint, with strong analytical skills