RevCycle Xperts, Inc. (RCX) is seeking certified, credentialed, and experienced ICD-10-CM/DRG reviewers to join its DRG and clinical validation team. The role focuses on revenue cycle integrity auditing across both provider and payer sides of healthcare delivery.
The company offers flexible scheduling with a minimum requirement of 20 hours per week. This position is fully remote and supports payer/insurance claim reviews, including complex case resolution.
Responsibilities include performing inpatient DRG validation reviews, determining the accuracy of billed DRGs using medical records and coding guidelines, identifying revised diagnosis and procedure codes when appropriate, using workflow and encoder tools efficiently, and meeting productivity and quality goals.
Qualifications
- Certified, credentialed, and experienced ICD-10-CM/DRG reviewer
- 4 to 5 years of experience preferred
- Expert inpatient coding skills with strong knowledge of ICD-10-CM and ICD-10-PCS
- Familiarity with Official Guidelines for Coding and Reporting and Coding Clinic guidance
- Knowledge of MS-DRG and APR-DRG payment methodologies
- Preferred credentials: CCS, CIC, RHIA, or RHIT
- 3+ years reviewing and/or auditing ICD-10-CM, MS-DRG, and APR-DRG claims preferred
- Experience working in a remote environment
- Strong written and verbal communication skills
- Proficiency with Windows-based computers, MS Office, Google applications, intranet, and internet tools
- Prior DRG retrospective overpayment identification auditing experience preferred
- Must be able to work a minimum of 20 hours per week
Benefits
- Flexible schedule
Location
N/A
Employment Type
Contractor
Experience Level
Senior
Remote work allowed
Yes
Posted
3 weeks ago