Job Description
In this role, you will review patient medical records to ensure clinical documentation accurately supports diagnoses, procedures, and DRG assignment in alignment with coding guidelines and regulatory standards. You will identify documentation gaps or inconsistencies that could impact reimbursement and work directly with physicians and care teams to obtain clarification through compliant queries and follow-up reviews. You will partner closely with coding teams to reconcile documentation with final coding outcomes, resolve DRG discrepancies, and ensure an accurate representation of patient severity of illness and level of care. Throughout your work, you will support documentation improvement initiatives, contribute to quality and compliance efforts, and leverage independent judgment to drive accuracy, reduce denials, and improve overall revenue cycle performance.

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