Supervisor, DRG Revenue Integrity

Education & Professional Development

• Participate in development and delivery of coding education for clients.
• Stay current on coding, reimbursement, and compliance issues through continuing education.
• Maintain active professional credentials as required.

Audit & Compliance

• Perform complex concurrent and/or retrospective analysis of medical record documentation to validate coded data.
• Ensure compliance with legal and procedural policies, official coding guidelines, and AHIMA Standards of Ethical Coding.
• Conduct independent QA on assigned Reviews/Audits results with a minimum accuracy expectation of 95%.
• Protect the privacy and confidentiality of patient and client health information at all times.

Reporting & Client Deliverables

• Analyze Reviews/Audits findings and identify root causes of coding errors.
• Prepare detailed summary reports of findings, citing official references.
• Ensure deliverables are accurate, timely, and aligned with client expectations.
• Act as client liaison/expert in organizational policies, maintaining an audit playbook for each assigned client.
• Provide back-up leadership support for client interactions when needed.

Special Projects

• Lead or participate in special projects requiring coding and auditing expertise across the organization.
• Support leadership in implementing new initiatives and process improvements.

Qualifications and Requirements:

• RHIA, RHIT, CCS, or CPC credential required.
• Minimum 5 years’ experience in DRG auditing, coding, or HIM consulting.
• Previous supervisory or lead auditor experience preferred.
• Strong knowledge of ICD-10-CM/PCS, CPT, MS-DRG, APR-DRG, and reimbursement methodologies.
• Excellent analytical, communication, and report-writing skills.
• Ability to manage multiple projects and priorities in a fast-paced consulting environment.

Performance Expectations

• Audit QA accuracy threshold: 95% minimum.
• Billable productivity threshold: 50% minimum (when client work is available).
• Demonstrated ability to apply coding principles consistently to evolving scenarios.

This is a remote position

PHYSICAL DEMANDS:
Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines.
A job description is only intended as a guideline and is only part of the Team Member’s function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.