TriWest Healthcare Alliance
Phoenix, AZ, USA
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We offer remote work opportunities (AK, AR, AZ, CO, FL, HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TN, TX, UT, VA/DC, WA, WI & WY only).
Our Department of Defense contract requires U.S. citizenship and a favorably adjudicated DOD background investigation for this position.
Veteran, Military Spouse or Military Affiliated are encouraged to apply!
Job Summary
Under the direction of the DRG Supervisor or designee, conducts retrospective medical claims review for coding and pricing determinations and/or coding review for inpatient (facility) claims to include diagnosis and procedural coding with DRG assignment (DRG Validation.) Subject matter expert on medical claims coding for outpatient and inpatient services. Provides coding-related information to medical directors, providers, peer reviewers, Claims...