DRG Auditor - Revenue Integrity

📋 Description

• • As a DRG Auditor - Revenue Integrity at Waystar Holding Corp., you will play a critical role in ensuring accurate hospital reimbursement by validating DRG assignments and supporting clinical documentation, directly impacting client financial performance and revenue cycle integrity.
• • Day to day, you will validate code and DRG assignment using physician documentation, UHDDS guidelines, and official coding standards via proprietary technology and medical records; assist in enhancing prediction models to improve verification rates; achieve and maintain client financial performance goals; and perform financial analysis reviews using Excel.
• • Waystar is a trusted healthcare payments platform serving over 1M providers, 1K+ hospitals, and 5K+ payers, committed to simplifying healthcare payments through innovative cloud-based technology, robust data, and exceptional client support, enabling providers to focus on patient care.
• • In this role, you will deepen your expertise in hospital inpatient coding, DRG validation (MS-DRG, APR-DRG), charge capture, and reimbursement methodologies; strengthen leadership and independent problem-solving abilities; and contribute to quality metrics initiatives like PSI and HAC, positioning yourself as a subject matter expert in revenue integrity.