DRG Coding Validation Specialist
The Rawlings Group | ||||||||||||||||||||||||||||||||
$73,000.00 - $105,000.00 / yr | ||||||||||||||||||||||||||||||||
life insurance, parental leave, paid holidays, tuition reimbursement, 401(k) | ||||||||||||||||||||||||||||||||
United States, California, Roseville | ||||||||||||||||||||||||||||||||
Jan 07, 2025 | ||||||||||||||||||||||||||||||||
Job Details
DRG Coding Validation Specialist
Who we Are As a leading healthcare intelligence company with over 40 years of experience, we put our unrivaled payment integrity, subrogation, and coordination of benefits (COB) expertise, expansive perspective, and relentless focus to work for our clients-ensuring no stone is left unturned in our pursuit of unmatched results. Our commitment to accuracy and excellence has helped us grow into a proven leader of our industry, relied on by companies large and small to help them maximize their return on investment. Location: This role is full remote About the Opportunity At NewCo, we're constantly reimagining what's possible in our industry-creating disruptively simple, powerfully clear ways to maximize our clients' financial outcomes today and drive down healthcare costs tomorrow. As part of the Complex Payment Solutions Team, as a DRG Coding Validation Specialist, you will conduct thorough reviews of provider medical records to validate the accuracy of ICD-10/PCS coding and ensure the correct assignment of Diagnosis-Related Groups (DRG). This role involves applying customer-specific payment policies, ensuring compliance with regulatory requirements, and supporting accurate reimbursement practices. The specialist works collaboratively with healthcare providers and internal teams to uphold coding quality standards, identify potential coding discrepancies, and provide detailed rationales for adjustments. By maintaining expertise in coding guidelines and industry standards, this position plays a vital role in safeguarding data integrity and optimizing financial outcomes. What you'll do
What experience you bring (Role Requirements) Certifications: (minimum of 1 of the following coding credentials required)
What Success Looks Like... After 3 months
After 1 year
Pay range: $73,000-$105,000 USD This is an exempt position. The salary range is for Base Salary.Compensation will be determined based on several factors including, but not limited to, skill set, years of experience, and the employee's geographic location. What's in it for you
At NewCo, we're reimagining a simpler way forward. This begins with our employees. We are innovators who value integrity, teamwork, accuracy, and flexibility. We do the right thing, and we listen to the needs of our clients and their members. As tenured experts with unmatched experience, we champion diverse perspectives that help us to better understand and serve our clients. Our values come to life through our culture. We embrace flexible working arrangements that allow our employees to bring innovation to life in the way that best suits their productivity. We work cross-functionally, abandoning silos, to bring innovative, accurate solutions to market. We invest in each other through ongoing education and team celebrations, and we give back to our communities through dedicating days for volunteering. Together, NewCo is making healthcare work better for everyone, and we're passionate about a future with better outcomes for all. We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We are proud to be an equal opportunity workplace. NewCo is an employment at will employer. #INDHP #LI-VPM |