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Auditor DRG Validation (CMS Audits)
Cotiviti • Remote, US • published 2026-09-22 16:42:36.719893
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Overview: This auditing role will focus on Coding \& Clinical Chart Validation for our Inpatient audits. The ideal candidate for this position needs to have a coding/auditing background focused on Inpatient DRG Coding from a coding and billing perspective. This position is responsible for auditing inpatient DRG and documenting the results of those audits with a focus on coding accuracy and the appropriateness of treatment setting and services delivered. **This role will start on XXX** Responsibilities: * Audits Inpatient DRG Claims: + Utilizes medical chart coding principles and client specific guidelines in performance of medical audit activities with Inpatient DRG claims. + Draws on advanced clinical expertise and industry knowledge to substantiate conclusions. + Performs work independently, reviews and interprets medical records and applies in\-depth knowledge of coding principles to determine potential billing/coding issues. * Effectively Utilizes Audit Tools. Utilizes Cotiviti proprietary auditing systems with a high level of proficiency to make audit determinations and generate audit letters. * Meets or Exceeds Standards/Guidelines for Productivity. Maintains production goals...
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