DRG Auditor – Revenue Integrity

Job Description

Join Waystar as a Revenue Integrity DRG Auditor, where you'll play a vital role in achieving client financial goals. Your mission involves validating code and DRG assignments using physician documentation, UHDDS guidelines, and official coding protocols. Leverage our proprietary technology and medical records to enhance verification rates through prediction improvements. Your expertise will directly impact our ability to maintain the highest standards of revenue cycle management and financial performance.

Qualifications

1. Minimum of 3 years' experience in inpatient auditing/coding with ICD and CPT/HCPCS. 2. Experience within a hospital setting is highly preferred. 3. Proficiency in MS-DRG validation, APR-DRG validation, and clinical validation. 4. Experience with PSI, HAC, and other quality metrics is advantageous. 5. Strong analytical and research skills are essential. 6. In-depth knowledge of coding hospital inpatient record types, clinical documentation, payer reimbursement methodologies, medical necessity criteria, billing requirements, and industry standards. 7. Commitment to staying current with ICD and CPT/HCPC coding requirements. 8. Proficiency with Microsoft Office and computerized programs/databases. 9. Excellent communication, judgment, discretion, and decision-making skills. 10. Self-motivated, hardworking with high attention to detail. 11. Excellent organizational skills.

Benefits

- Competitive total rewards package (base salary + bonus, if applicable). - Customizable benefits package including multiple medical plans with Health Saving Account company match. - Generous paid time off: starting with 3 weeks + 13 paid holidays for non-exempt team members, including 2 personal floating holidays; flexible time off + 13 paid holidays for exempt team members. - Paid parental leave, covering maternity and paternity. - Education assistance opportunities and free access to LinkedIn Learning. - Comprehensive mental health and family planning programs, including adoption assistance and fertility support. - 401(K) program with company match. - Pet insurance options. - Inclusion in employee resource groups.