Job Details

A company is looking for a Consultant II Ideation & Analytics DRG.Key ResponsibilitiesDevelop and implement an effective DRG audit program, including rules for claim identification and review guidelinesIdentify and create concepts for recognizing incorrect payments based on industry experience and regulatory researchResearch reimbursement regulations and update audit recovery reports and custom queriesRequired QualificationsBachelor's degree in Science, Pharmacy, or Nursing5+ years of experience in the healthcare industry, with a focus on Payer3+ years of experience in DRG Coding, Clinical Validation, or as a DRG Quality Auditor1+ year of experience in research and ideation for clinical audit programsProficiency in MS Word, Excel, and PowerPoint is preferred