Diagnosis Related Group (DRG) - Quality Analyst

Responsibilities

• Apply clinical judgment for DRG audits to ensure accuracy of inpatient DRG coding
• Responsible for reviewing the accuracy and consistency of clinical DRG auditing auditors to ensure audits are appropriately marked for findings and no findings
• Mentor Clinical DRG auditors
• Recommend process changes to improve quality and performance
• Communicate with peers and management
• Perform root cause analysis on errors
• Conduct other duties as assigned

Qualifications

• Minimum 5 years experience working with clinical validation audits
• Superior auditing and monitoring skills
• Excellent decision making skills and sound judgment
• Thorough understanding of medical terminology and human physiology
• Strong technical knowledge and ability to learn new systems quickly
• Excellent oral/presentation and written communication skills
• Strong organizational skills and attention to detail
• Ability to work in a team environment and independently as needed
• Demonstrated flexibility and adaptability
• Must be able to work under deadlines
• Must be able to utilize independent decision-making skills in a wide variety of situations
• Requires a high degree of accuracy in the performance of varied responsibilities