Loads and validates hospital chargemaster and healthcare data into SQL databases using Excel templates and proprietary tools. Maintains databases, retrieves CMS data, prepares spreadsheets and reports, tracks client tasks, and supports financial analytics. Collaborates closely with clients and internal teams to ensure accurate, timely deliverables and provides client support. Requires knowledge of chargemaster elements, healthcare financial and patient accounting data, EHR systems, SQL, and advanced Excel proficiency.

Supervise DRG coding audits, ensuring compliance with coding guidelines, provide training, conduct quality assurance, and generate reports for clients.

Audits zero-balance hospital accounts to identify underpaid inpatient and outpatient claims. Reviews payer contracts, medical records, policies, regulations, and payment data; models reimbursement methodologies; researches underpayment trends; and develops audit plans, pricing documents, and technical procedures using Excel, Access, and SQL. Senior auditors lead complex investigations, provide quality reviews, mentor staff, and recommend process improvements.