ABOUT THIS POSITION
We are looking for a Revenue Integrity DRG Auditor who has a comprehensive understanding of hospital Revenue Cycle Management. Significant experience in the following areas: hospital inpatient coding, DRG assignment, charge capture, and hospital reimbursement methodologies. The candidate must have experience with using excel and performing financial analysis reviews. The ideal candidate for this position can approach problem-solving challenges independently, possess leadership experience, strong attention to detail, can provide outstanding customer service and enjoys working in a fast-paced, collaborative and team-based environment.WHAT YOU'LL DO
Achieve and maintain assigned client financial performance goals
Validate code and DRG assignment and supporting clinical documentation based on physician documentation, UHDDS guidelines and official coding guidelines using proprietary technology and medical records
Assist in prediction enhancements to increase verification rates
WHAT YOU'LL NEED
Self-sufficient with strong analytical and research skills
In depth knowledge related to coding hospital inpatient record types, clinical documentation, payer reimbursement methodology, medical necessity criteria, billing requirements and applicable industry based standards
Remain current on ICD and CPT/ HCPC coding requirements
Proficient with Microsoft Office products and possess the ability to work effectively with computerized programs and databases
Ability to communicate effectively
Demonstrate independent judgment, discretion, and decision making abilities
Self-motivated, hardworking individual with a high attention to detail
Excellent organization skills
Experience
3+ years of inpatient auditing/coding experience with ICD and CPT/HCPCS
Experience working within the hospital environment preferred
Experience in MS-DRG validation, APR-DRG validation and clinical validation
Experience related to PSI, HAC, and other quality metrics is a plus
Education/Certification
CCS, CPC, RHIT, RHIA, CDIP, CCDS or other coding/clinical certifications, credentials, or expertise preferred
ABOUT WAYSTAR
Through a smart platform and better experience, Waystar helps providers simplify healthcare payments and yield powerful results throughout the complete revenue cycle.
Waystar’s healthcare payments platform combines innovative, cloud-based technology, robust data, and unparalleled client support to streamline workflows and improve financials so providers can focus on what matters most: their patients and communities. Waystar is trusted by 1M+ providers, 1K+ hospitals and health systems, and is connected to over 5K commercial and Medicaid/Medicare payers. We are deeply committed to living out our organizational values: honesty; kindness; passion; curiosity; fanatical focus; best work, always; making it happen; and joyful, optimistic & fun.
Waystar products have won multiple Best in KLAS® or Category Leader awards since 2010 and earned multiple #1 rankings from Black Book™ surveys since 2012. The Waystar platform supports more than 500,000 providers, 1,000 health systems and hospitals, and 5,000 payers and health plans. For more information, visit waystar.com or follow @Waystar on Twitter.
WAYSTAR PERKS
- Competitive total rewards (base salary + bonus, if applicable)
- Customizable benefits package (3 medical plans with Health Saving Account company match)
- We offer generous paid time off for our non-exempt team members, starting with 3 weeks + 13 paid holidays, including 2 personal floating holidays. We also offer flexible time off for our exempt team members + 13 paid holidays
- Paid parental leave (including maternity + paternity leave)
- Education assistance opportunities and free LinkedIn Learning access
- Free mental health and family planning programs, including adoption assistance and fertility support
- 401(K) program with company match
- Pet insurance
- Employee resource groups
Waystar is proud to be an equal opportunity workplace. We celebrate, value, and support diversity and inclusion. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, marital status, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.
This applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.
Top Skills
Similar Jobs
What you need to know about the Boston Tech Scene
Key Facts About Boston Tech
- Number of Tech Workers: 269,000; 9.4% of overall workforce (2024 CompTIA survey)
- Major Tech Employers: Thermo Fisher Scientific, Toast, Klaviyo, HubSpot, DraftKings
- Key Industries: Artificial intelligence, biotechnology, robotics, software, aerospace
- Funding Landscape: $15.7 billion in venture capital funding in 2024 (Pitchbook)
- Notable Investors: Summit Partners, Volition Capital, Bain Capital Ventures, MassVentures, Highland Capital Partners
- Research Centers and Universities: MIT, Harvard University, Boston College, Tufts University, Boston University, Northeastern University, Smithsonian Astrophysical Observatory, National Bureau of Economic Research, Broad Institute, Lowell Center for Space Science & Technology, National Emerging Infectious Diseases Laboratories
