Supervisor, Payment Integrity- Coding & Clinical (DRG)

Supervise and coordinate daily activities of the Coding & Clinical Review team to ensure accurate DRG assignment, clinical validation, and audit outcomes aligned with policies and regulatory requirements. Monitor team performance against productivity and quality expectations, providing guidance on coding determinations per ICD-10-CM/PCS guidelines and DRG methodologies. Review and resolve complex or escalated cases, elevate high-risk issues to management, and conduct quality assurance activities including audits and calibration sessions. Analyze operational data to identify trends and improvement opportunities, while supporting appeals processes by reviewing clinical documentation and guiding response development. Collaborate with cross-functional partners to address issues and ensure compliance with payer guidelines and AHIMA ethical standards.