Inpatient DRG Validator & Coding Analyst

About the role

As an Inpatient DRG Validator & Coding Analyst, you will work closely with the Supervisor/Manager of Revenue Integrity Services to achieve the Revenue Integrity Service Line’s goals and the company’s broader objectives. You will support the Kodiak Service Line by providing inpatient coding reviews and assisting other service lines, helping healthcare organizations streamline complex financial operations and optimize processes.

Responsibilities

• Read, decipher, and analyze all aspects of medical record documentation to ensure accurate coding.
• Review inpatient coding (ICD-10-CM and ICD-10-PCS codes) to ensure accuracy and completeness of records coded by the coding staff for multiple clients.
• Validate ICD-10-CM and PCS codes, principal and secondary diagnoses, and assignment appropriateness to optimize DRG reimbursement and ensure data quality.
• Review physician documentation for specificity, completeness, and quality to support coding accuracy and identify physician query opportunities.
• Maintain current knowledge of regulatory agency standards (e.g., CMS, OIG, AHA, Coding Clinics).
• Maintain required coding credential(s).
• Seek opportunities for individual growth and development, including attending meetings, conferences, and courses as required.
• Meet departmental productivity and quality expectations.
• Consult with client organizations and their department heads at the direction of the service line director.
• Collaborate with other service line team members to meet client demands and develop strategies for service line growth and operational improvement.

Requirements

• A minimum of 5+ years’ experience with Coding IP Claims.
• CCS (Certified Coding Specialist) credential required.
• Experience with Medicare and Medicaid DRGs.
• Experience with DRG Validator.
• Experience with OP coding is a plus.
• Strong coding knowledge and adherence to official coding rules, guidelines, and conventions to ensure compliance and high-quality coded data.
• Competency in using computer applications in EHR systems (e.g., Cerner, EPIC, Meditech) and DRG grouping software.
• Proficiency in MS Office and in-house proprietary software.
• Knowledge of hospital/healthcare settings, including revenue cycle, coding, and reimbursement.
• Knowledge of ICD-10-CM/PCS required.
• ICD-10-CM/PCS AHIMA Approved Trainer experience highly desired.
• Excellent oral and written communication skills, including the ability to interact with high-level management.
• Detailed-oriented with the ability to meet targeted deadlines.

Qualifications

• Bachelor of Science degree in a related field; Associate’s in Health Information Technology minimally acceptable.
• RHIA or RHIT certification is a plus.

Candidates must be legally authorized to work in the United States. This position is not eligible for employment visa sponsorship now or in the future.