DRG Auditor - Revenue Integrity

ABOUT THIS POSITION We are looking for a Revenue Integrity DRG Auditor who has a comprehensive understanding of hospital Revenue Cycle Management. Significant experience in the following areas: hospital inpatient coding, DRG assignment, charge capture, and hospital reimbursement methodologies. The candidate must have experience with using excel and performing financial analysis reviews. The ideal candidate for this position can approach problem-solving challenges independently, possess leadership experience, strong attention to detail, can provide outstanding customer service and enjoys working in a fast-paced, collaborative and team-based environment. WHAT YOU'LL DO

• Achieve and maintain assigned client financial performance goals
• Validate code and DRG assignment and supporting clinical documentation based on physician documentation, UHDDS guidelines and official coding guidelines using proprietary technology and medical records
• Assist in prediction enhancements to increase verification rates

WHAT YOU'LL NEED

• Self-sufficient with strong analytical and research skills
• In depth knowledge related to coding hospital inpatient record types, clinical documentation, payer reimbursement methodology, medical necessity criteria, billing requirements and applicable industry based standards
• Remain current on ICD and CPT/ HCPC coding requirements
• Proficient with Microsoft Office products and possess the ability to work effectively with computerized programs and databases
• Ability to communicate effectively
• Demonstrate independent judgment, discretion, and decision making abilities
• Self-motivated, hardworking individual with a high attention to detail
• Excellent organization skills

Experience

• 3+ years of inpatient auditing/coding experience with ICD and CPT/HCPCS
• Experience working within the hospital environment preferred
• Experience in MS-DRG validation, APR-DRG validation and clinical validation
• Experience related to PSI, HAC, and other quality metrics is a plus

Education/Certification

• CCS, CPC, RHIT, RHIA, CDIP, CCDS or other coding/clinical certifications, credentials, or expertise preferred

ABOUT WAYSTAR Through a smart platform and better experience, Waystar helps providers simplify healthcare payments and yield powerful results throughout the complete revenue cycle. Waystar's healthcare payments platform combines innovative, cloud-based technology, robust data, and unparalleled client support to streamline workflows and improve financials so providers can focus on what matters most: their patients and communities. Waystar is trusted by 1M+ providers, 1K+ hospitals and health systems, and is connected to over 5K commercial and Medicaid/Medicare payers. We are deeply committed to living out our organizational values: honesty; kindness; passion; curiosity; fanatical focus; best work, always; making it happen; and joyful, optimistic & fun. Waystar products have won multiple Best in KLAS® or Category Leader awards since 2010 and earned multiple #1 rankings from Black Book™ surveys since 2012. The Waystar platform supports more than 500,000 providers, 1,000 health systems and hospitals, and 5,000 payers and health plans. For more information, visit waystar.com or follow @Waystar on Twitter. WAYSTAR PERKS

• Competitive total rewards (base salary + bonus, if applicable)
• Customizable benefits package (3 medical plans with Health Saving Account company match)
• We offer generous paid time off for our non-exempt team members, starting with 3 weeks + 13 paid holidays, including 2 personal floating holidays. We also offer flexible time off for our exempt team members + 13 paid holidays
• Paid parental leave (including maternity + paternity leave)
• Education assistance opportunities and free LinkedIn Learning access
• Free mental health and family planning programs, including adoption assistance and fertility support
• 401(K) program with company match
• Pet insurance
• Employee resource groups

Waystar is proud to be an equal opportunity workplace. We celebrate, value, and support diversity and inclusion. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, marital status, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws. This applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training. Apply tot his job Apply To this Job