Senior Manager - DRG Concept Development Analyst
About The Position
As a DRG Concept Development Analyst, you will collaborate with Payment Integrity Audit program leaders, DRG audit professionals and Data & Analytic team members to research, d develop and implement inpatient DRG audit selection criteria. This role involves analyzing performance metrics and results to ensure alignment with our team goals. The successful candidate will be quality focused, possess strong analytical skills and have a background in payment integrity audits. The successful candidate will demonstrate mastery-level coding skills in ICD-10-CM and PCS, along with extensive knowledge and expertise in the application of ICD-10 Official Coding Guidelines and AHA Coding Clinic guidelines. They will possess an advanced understanding of MS DRG and APR-DRG reimbursement methodologies and remain current with relevant regulatory changes.
Requirements
- quality focused
- strong analytical skills
- background in payment integrity audits
- mastery-level coding skills in ICD-10-CM and PCS
- extensive knowledge and expertise in the application of ICD-10 Official Coding Guidelines and AHA Coding Clinic guidelines
- advanced understanding of MS DRG and APR-DRG reimbursement methodologies
- remain current with relevant regulatory changes
Responsibilities
- collaborate with Payment Integrity Audit program leaders, DRG audit professionals and Data & Analytic team members to research, develop and implement inpatient DRG audit selection criteria
- analyzing performance metrics and results to ensure alignment with our team goals
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What This Job Offers
Job Type
Full-time
Career Level
Manager
Education Level
No Education Listed
