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Diagnosis Related Group Specialist at Montefiore

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Diagnosis Related Group Specialist

External

Montefiore · 555 South Broadway

Full-timeOn-siteToday

AuditingComplianceDocumentationEpic

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Requirements

High School Diploma or equivalent required
Associate's or Bachelor's degree preferred
CCS required
RHIA/RHIT, CPC, CRC, CDIP, or CCDS preferred
Minimum of 5 years coding experience preferred (acute care strongly preferred)

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Minimum of 2 years auditing/quality review experience preferred

Demonstrated expertise in DRG and inpatient coding principles required if assigned to IP audits

Expert-level knowledge of official coding guidelines and sequencing rules

Strong clinical documentation interpretation skills

Ability to apply independent professional judgment in audit conclusions

Ability to clearly articulate and defend audit outcomes using guidelines

Strong written communication skills for defensible documentation

Strong attention to detail, productivity focus, and ability to meet strict deadlines

Proficiency in Epic and related coding/audit tools preferred

Ability to work independently with minimal supervision while remaining accountable for quality and timeliness

Benefits

Vision insurance

Additional Information

City/State: Tarrytown, New York Grant Funded: No Department: HIM - Clinical Coding - Qlty and Integrity Work Shift: Day Work Days: MON-FRI Scheduled Hours: 8:30 AM-4:30 PM Scheduled Daily Hours: 7.5 HOURS Pay Range: $68,000.00-$85,000.00 Job Summary The DRG Validator is a coding quality and compliance professional responsible for conducting complex and high-impact coding audits across inpatient (IP) encounters. Validates code accuracy, guideline compliance, and documentation support to ensure coding integrity and reduce denial risk. This role supports organizational coding quality initiatives by identifying audit trends, performing root cause analysis, ensuring audit defensibility, providing coder feedback, and supporting coding education strategies. The DRG Validator is required to use approved audit tools and scrubbers, including PWC SMART, to support audit targeting, audit documentation, and review consistency.

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