Supervisor, DRG Revenue Integrity

CorroHealth-posted 2 days ago
Full-time • Mid Level
Plano, TX
5,001-10,000 employees
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Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals. We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success. JOB SUMMARY: The Supervisor, DRG Integrity Reviews/Audits, is responsible for overseeing the execution, quality, and delivery of complex, concurrent, and retrospective coding audits. This role ensures compliance with AHA, CMS, AMA, AHIMA, AAPC, Coding Clinic, CPT Assistant, and official coding guidelines, while supervising a team of auditors. The Supervisor provides second-level review, client deliverables, coding education, and quality assurance to support both client and organizational goals.

  • Coordinate scheduling of team and client deliverables with leadership.
  • Assign new clients to auditors, send weekly assignments, and ensure access to client information.
  • Provide auditors with timely updates/changes to coding guidelines and department processes.
  • Serve as a Subject Matter Expert (SME) for auditors across assigned audits.
  • Conduct training for new and existing auditors to maintain team competency.
  • Provide insight to auditor performance; productivity, quality and opportunity find rates
  • Conduct QA of at least 25% of departmental work products, ensuring a minimum 95% accuracy threshold.
  • Promote teamwork, knowledge sharing, and respectful communication across the team.
  • Meet productivity standards set by record type for each audit.
  • Maintain billable productive hours at or above 80% when client work is available.
  • Monitor and report time, work products, and schedules in an accurate and timely manner.
  • Recommend process improvements to streamline workflows and enhance efficiency.
  • Participate in development and delivery of coding education for clients.
  • Stay current on coding, reimbursement, and compliance issues through continuing education.
  • Maintain active professional credentials as required.
  • Perform complex concurrent and/or retrospective analysis of medical record documentation to validate coded data.
  • Ensure compliance with legal and procedural policies, official coding guidelines, and AHIMA Standards of Ethical Coding.
  • Conduct independent QA on assigned Reviews/Audits results with a minimum accuracy expectation of 95%.
  • Protect the privacy and confidentiality of patient and client health information at all times.
  • Analyze Reviews/Audits findings and identify root causes of coding errors.
  • Prepare detailed summary reports of findings, citing official references.
  • Ensure deliverables are accurate, timely, and aligned with client expectations.
  • Act as client liaison/expert in organizational policies, maintaining an audit playbook for each assigned client.
  • Provide back-up leadership support for client interactions when needed.
  • Lead or participate in special projects requiring coding and auditing expertise across the organization.
  • Support leadership in implementing new initiatives and process improvements.
  • RHIA, RHIT, CCS, or CPC credential required.
  • Minimum 5 years’ experience in DRG auditing, coding, or HIM consulting.
  • Strong knowledge of ICD-10-CM/PCS, CPT, MS-DRG, APR-DRG, and reimbursement methodologies.
  • Excellent analytical, communication, and report-writing skills.
  • Ability to manage multiple projects and priorities in a fast-paced consulting environment.
  • Audit QA accuracy threshold: 95% minimum.
  • Billable productivity threshold: 50% minimum (when client work is available).
  • Demonstrated ability to apply coding principles consistently to evolving scenarios.
  • Previous supervisory or lead auditor experience preferred.
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