In these fully remote positions as credentialed Coding/DRG Validators and Clinical Documentation Validators, you will apply your expert knowledge of DRG reimbursement methodology, ICD-10 Official Coding Guidelines, and AHA Coding Clinic Guidelines, Clinical Diagnoses Criteria to audit inpatient medical records to validate or revise ICD/DRG/CPT code assignments.

You will utilize industry standardized clinical criteria (such sepsis -01, 02, 03, etc.) and RCX proprietary techniques to review clinical documentation coding rules and guidelines to ensure all codes and DRG assigned are supported by the source documentation. Write professional summary documenting review conclusions citing supporting rules, guidelines, and definitions.

As ValidationConsultants, you will also apply your extensive coding/DRG and Clinical Documentation knowledge to identify trends and identify referrals for DRG / Clinical Validation review.