Payment Integrity DRG Coding & Clinical Validation Analyst I/II/III (RHIA, RHIT, CCS, or CIC Certification Required)
Excellus BCBS(4 months ago)
About this role
A Payment Integrity DRG Coding & Clinical Validation Analyst at a health plan ensures the integrity of inpatient coding and DRG assignments by applying knowledge of clinical documentation and payment systems. The role supports accurate hospital billing and compliance with regulatory coding guidelines across multiple experience levels (Level I–III).
Required Skills
- ICD-10CM
- MS-DRG
- APR-DRG
- Medical Coding
- Chart Review
- Clinical Validation
- Auditing
- DRG Grouper
- Claims Processing
- Regulatory Compliance
+2 more
Qualifications
- Associate Degree in Health Information Management
- Bachelor's Degree in Health Information Management
- Nursing Degree
- RHIA
- RHIT
- CCS
- CIC
About Excellus BCBS
excellusbcbs.comOfficial site of Excellus BCBS, a trusted health insurance plan for over 85 years. Shop for affordable health plans including Medicare, medical, dental, vision, and employer plans.
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