Position Overview
**Job Summary**
The DRG Denials Auditor conducts hospital inpatient DRG denial audits for both RAC and non-RAC accounts, reviewing patient records for accuracy in ICD-10-CM/PCS coding, DRG assignments, and supporting clinical documentation. This includes evaluating present on admission (POA) indicators, discharge disposition, and any other relevant data to ensure coding accuracy. The auditor is also responsible for writing and defending appeal letters to payers with a strong attention to detail. Additionally, the auditor provides audit feedback to relevant parties, including coders and coding managers, to improve coding practices and compliance.
**Essential Functions**
+ Performs inpatient denial reviews using ICD-10-CM/PCS and DRG validation utilizing appropriate coding references for CHS hospitals via scanned, electronic and hybrid medical records. Based on review findings, writes appeal letters to include supporting documentation.
+ Utilizes hospital ab...