What are the responsibilities and job description for the Medical Coding Auditor – DRG position at Hornet Staffing, Inc, a GEE Group company?
We are seeking a detail-oriented Medical Coding Auditor – DRG to join a high-volume medical review team. This role focuses on validating DRG assignments, medical coding accuracy, and claims integrity to support cost control and compliance.
✅ Key Responsibilities
- Perform DRG validation reviews on inpatient medical records
- Audit coding accuracy and identify discrepancies in claims
- Coordinate with claims teams to implement rate adjustments
- Analyze trends and prepare monthly & quarterly audit reports
- Ensure compliance with HIPAA and documentation standards
- Act as a subject matter expert for coding and audit-related issues
✅ Required Qualifications
- Certification required: CPC, RHIT, RHIA, CPMA, or CIC
- Minimum 3 years of experience in medical coding & auditing
- Strong knowledge of ICD-10, DRG, and inpatient coding
- Experience in medical record review and validation
- Understanding of payer guidelines and claims auditing
✅ Preferred Qualifications
- Experience with DRG validation and inpatient audits
- Prior payer-side experience (BCBS, Optum, etc.)
- Strong analytical, reporting, and documentation skills
Salary : $36