State Licensed DRG Auditor - Anaheim California

Company: VirtualVocations
Location: Anaheim, California
Posted On: 02/06/2025

A company is looking for a Diagnosis Related Group - Auditor III - Appeals.



Key Responsibilities:

Review MS-DRG and/or APR-DRG provider appeals for accuracy in DRG assignment and reimbursement
Document appeal results clearly, citing appropriate coding guidelines
Identify and communicate audit trends and perform audits as needed


Required Qualifications:

7+ years of experience in MS-DRG and APR-DRG auditing
Expert knowledge of AHA Coding Guidelines and DRG reimbursement methodologies
Active AHIMA CCS certification
Experience with DRG encoder tools (3M, Webstrat, Pricers)
Prior experience managing provider DRG appeals More...

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