DRG Claims Auditor, Recoveries
This job is no longer available
There are still lots of open positions. Let's find the one that's right for you.
About The Position
Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham. The DRG Claims Auditor, Recoveries role involves performing DRG validation and quality audit on claims, providing coding expertise in the application of medical and reimbursement policies within the claim adjudication process through document review, interpretation of state and federal mandates, applicable benefit language, coding requirements, and consideration of relevant clinical information with a focus on overpayment identification. This role recovers inaccurately paid DRG claims submitted by providers, with an increasing number of contracts being moved from a percentage of charge to DRG-based reimbursement.
