Senior Auditor, Clinical Validation (Inpatient Focus) - Temp to Hire

Are you a seasoned CDI / DRG auditor with a strong clinical background and a passion for ensuring accuracy in medical claims? Our client is seeking a highly skilled Senior CDI / DRG Auditor to join their dynamic team, focusing on inpatient coding and clinical chart validation. This is a temp-to-hire opportunity offering a competitive salary based on experience. As a Senior CDI / DRG Auditor, you will play a critical role in analyzing and auditing inpatient claims, utilizing your clinical expertise and advanced coding knowledge to ensure accuracy and compliance. This role demands a deep understanding of ICD-10 coding, DRG/APR-DRG methodologies, and the ability to work independently to deliver high-quality audit results.

Analyze and Audit Claims: Apply medical chart coding principles, clinical guidelines, and advanced ICD-10 coding expertise to review and audit medical records or episodes of care. Utilize industry knowledge to justify audit conclusions, working independently. Utilize Audit Tools Effectively: Proficiently operate proprietary systems to make audit determinations and draft audit letters. Meet Productivity Goals: Maintain production targets established by audit operations management. Ensure Accuracy and Quality: Achieve expected standards of accuracy and quality in claim identification and documentation, including letter writing. Identify Opportunities for Improvement: Suggest potential recoveries or improvements in auditing processes, concepts, and tools. Complete Assigned Responsibilities: Fulfill all duties outlined in the annual performance plan and complete special projects as assigned. Perform with or without Accommodation: Demonstrate adaptability and inclusivity to perform tasks effectively.