DRG Review Coder (In Office)

Location: New York City, NY
Date Posted: 11-26-2018

DRG Review Coder – Managed Care
New York, NY (Manhattan, Financial District)

*** Multiple, Full-Time, Permanent, IN-OFFICE opportunities in the greater New York City area! ***

DRG Review Coder Job Summary: 

  • Validate ICD-9/10  coding to ensure proper DRG assignment in order to screen out over billed cases
  • Validate/assign CPT codes to assure proper billing
  • Refer cases with possible utilization and/or quality issues
  • Bring to the attention of the managers and other key staff involved in the review process of any other issues and problems that case review may present
  • Perform on-site reviews within and outside of New York State as assigned
  • Perform varied types of reviews in central office when assigned
  • Adhere to and maintain qualitative and quantitative standards
  • Coordinate and collaborate on scheduled on-site reviews with other reviewers and the host department in order to ensure the timely completion of the review
  • Record review decisions and justifications for changes requested or issues raised
  • Report daily and weekly output
  • Inform the personnel involved in the review process of any applicable coding guidelines, conventions and information that will ensure quality in DRG reviews

DRG Review Coder Background: 
  • High School diploma or equivalent; Associate or Bachelor degrees are a plus.
  • AHIMA or AAPC approved credentials, such as:  Certified Coding Specialist (CCS), Certified Professional Coder (CPC), Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), or similar.
  • At least 2 years of inpatient medical coding with ICD-9-CM / CPT & ICD-10.
  • Knowledge of MS-DRG classification and reimbursement structures.
  • Proficient at writing AHIMA complaint physician queries.
  • Adept at comparing documentation, code assignment and charge in the financial system for accuracy and completeness and elevating concerns to the appropriate manager.
  • Ability to use office equipment and automated systems/applications/software at an acceptable level of proficiency.
  • Functional knowledge of facility EMR, encoder and other support software.


623.201.8732 (CALL – TEXT – FAX)
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