Nurse Coder DRG Auditor I (US Remote)

At Trend Health Partners , a tech-enabled payment integrity company, our mission is to facilitate collaboration between payers and providers for mutual benefit and waste reduction, ultimately improving access to healthcare. We achieve this by aligning the common goals of payers and providers and fostering collaboration through a shared technology platform and seamless workflows. Joining Trend Health Partners means becoming a part of a dynamic growing organization that promotes a collaborative and innovative work environment. Our comprehensive compensation package includes competitive salaries, highly valued health insurance, a 401(k) plan with employer match, paid parental leave, and more. The Nurse Coder DRG Auditor’s primary responsibility is to review medical records and associated claim information to validate accuracy of DRG assignments, APC assignments and/or medical necessity for inpatient level of care. This role will apply coding and clinical principles based on industry standards and company/client guidelines. Role and Responsibilities Utilize coding guidelines and clinical guidelines to perform DRG or APC validation Validate principal diagnosis, secondary diagnoses, sequencing of diagnoses, discharge statuses and procedures utilizing the medical record Evaluate short stay claims for medical necessity of an inpatient level of care Apply CPT and ICD-10 guidelines Apply policies, procedures, guidelines and regulations developed by Centers for Medicare and Medicaid Ser