DRG Audit Program Director
DRG Audit Program Director
HealthCare Support is seeking a DRG Audit Program Director to fill an opening with a Payment Integrity and Claims Review Company in Fort Worth, TX!
Daily Responsibilities for DRG Audit Program Director :
- Leads a team that reviews hospital bills to make sure insurance companies are paying the correct amount
- Finds and fixes errors in how medical treatments are coded and documented to prevent overpayments
- Makes sure the information in patient records is complete and accurate
- Helps improve the processes that hospitals and coders use to ensure billing is done properly
- Works closely with different departments to improve how healthcare payments are reviewed and managed
- Hybrid Role I Monday-Friday, daytime hours
Required Qualifications for DRG Audit Program Director :
- Bachelor's degree in Health Information Management (HIM), Nursing, Healthcare Administration, or a related field
- Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), Certified Clinical Documentation Specialist (CCDS) or Certified Inpatient Coder (CIC) through the AHIMA (American Health Information Management Association)
- 7-10 years of progressive experience in DRG coding, clinical validation, medical auditing, or payment integrity, with a strong focus on inpatient DRGs (MS-DRG, APR-DRG, AP-DRG)
- 3-5 years of leadership or management experience in a healthcare audit or payment integrity setting
- Experience with ICD-9/10-CM/PCS coding guidelines, Medicare and Commercial coding rules, regulations, and prospective payment systems
- Proven experience in managing and developing audit programs
- Experience with Readmission reviews is a plus
Benefits for DRG Audit Program Director :
- Benefit coverage begins 1st of the month following 60 days of employment
- Medical (Regence Blue or Kaiser), Vision, Dental
- PTO: 10 days
- 7 Paid Holidays, 2 Floating Holidays, and 2 weeks of sick time
- HSA, Life, AD&D, and 401K Discretionary Match
Pay Details:
- $160,000 – $175,000
Interested in being considered?
If you are interested in applying to this position, email Melanie Williams a copy of your resume at melanie.williams@healthcaresupport.com with the job title and location, and she will reach out.
Healthcare Support Staffing, LLC. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.
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