Job Profile Summary: The DRG Validator will be responsible for coordinating coding audits and education for Sturdy Memorial Hospital inpatient coding services. Quality reviews are performed to validate the ICD-10-CM and ICD-10-PCS codes, DRG appropriateness, missed secondary diagnoses and procedures, and ensure compliance and accuracy of the MS-DRG, APR DRG and other reimbursement(s) impacting elements. In addition, the DRG Validator will prepare, and present educational programs based upon audit findings. Other responsibilities include coding to support timely billing, writing appeal letters for DRG denials, and drafting coding guidelines to ensure coding consistency. The DRG Validator is responsible for exceeding quality and quantity expectations when performing coding and audit related functions.
