About Us:

Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals. 

We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success.  

ESSENTIAL DUTIES AND RESPONSIBILITIES: 
Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member.

Key Responsibilities :

• Assist in managing CDI and inpatient DRG audit programs across multiple service lines. 

• Conduct and oversee retrospective audits for documentation and coding compliance. 

• Review high-risk DRGs such as sepsis, respiratory failure, AKI, and malnutrition. 

• Develop and maintain audit policies, procedures, and workflows. 

• Monitor audit metrics including accuracy, agreement rates, financial impact, and query effectiveness. 

• Provide mentorship, training, and performance guidance to CDI and auditing staff. 

• Collaborate with physicians, coding, quality, compliance, and revenue cycle teams. 

• Create dashboards and reports to communicate financial and quality outcomes. 

• Support the use of technology, analytics, and AI tools to enhance audit effectiveness. 

• Assist in building or expanding DRG validation and audit programs. 

Qualifications :

Education 

Registered Nurse (RN), MBBS, BDS, BAMS OR equivalent Clinical Degree  

Experience 

5+ years in CDI, inpatient coding, auditing, or revenue integrity. 

Experience leading or supporting CDI and DRG audit programs. 

Skills 

Strong analytical, leadership, and communication skills. 

Knowledge of MS-DRGs, ICD-10-CM/PCS, and regulatory guidelines

PHYSICAL DEMANDS:
Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines.
A job description is only intended as a guideline and is only part of the Team Member’s function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.