Diagnosis Related Group (DRG) Auditor III

EXL Health; United States; Remote; USD 70,000 - 80,000; Full time

Job summary

An innovative healthcare firm is seeking a passionate DRG Auditor III to thrive in a fully remote role. This position offers a unique opportunity to make a significant impact in healthcare auditing while enjoying the flexibility of working from home. You will conduct comprehensive coding reviews, ensure accuracy in DRG assignments, and utilize industry-leading tools to identify overpayments. With a strong focus on career development and a supportive culture, this role is perfect for those eager to grow professionally while maintaining a healthy work-life balance. Join a team of experts and contribute to excellence in healthcare.

Benefits

Medical Insurance

Vision Insurance

Dental Insurance

401(k) Options

Paid Maternity Leave

Paid Paternity Leave

Career Development Programs

Mentorship Opportunities

Flexible Work Environment

Competitive Benefits Package

Qualifications

• 4+ years of MS-DRG/APR-DRG coding experience required.
• Expert-level inpatient coding knowledge with ICD-10-CM/PCS guidelines.
• Strong proficiency with DRG encoder tools and coding guidelines.

Responsibilities

• Conduct comprehensive MS-DRG and APR-DRG coding reviews.
• Utilize advanced DRG encoder tools to drive efficiency in audits.
• Craft clear audit findings backed by coding guidelines.

Skills

MS-DRG Coding

APR-DRG Coding

AHA Coding Guidelines

DRG Reimbursement Methodologies

Time Management

Problem-Solving

Analytical Skills

Written Communication

Verbal Communication

Education

High School Diploma

CCS Credential

RHIA Credential

RHIT Credential

Tools

3M DRG Encoder

Webstrat

Excel

Word

OneNote

Job description

Diagnosis Related Group (DRG) Auditor III

Join to apply for the Diagnosis Related Group (DRG) Auditor III role at EXL Health

Diagnosis Related Group (DRG) Auditor III

6 days ago Be among the first 25 applicants

Join to apply for the Diagnosis Related Group (DRG) Auditor III role at EXL Health

This range is provided by EXL Health. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

Base pay range

$70,000.00/yr - $80,000.00/yr

Direct message the job poster from EXL Health

Talent Acquisition Recruiting and HR Assistant at EXL Health

Join Our Team as a DRG Auditor III – Make an Impact in Healthcare!

Are you a passionate and experienced DRG Auditor looking for an opportunity to thrive in a dynamic, innovative environment? EXL USA Healthcare is seeking a DRG Auditor III to join our team! This role offers a fully remote work experience with possible 10% travel per year. The rest of the time, you'll enjoy the flexibility of working from your home office.

Why EXL?

At EXL, we believe in fostering an environment where our employees can learn, grow, and succeed. We provide industry-leading training, career development opportunities, and a competitive benefits package to ensure you can focus on what you do best—delivering excellence in DRG auditing. If you're looking for a role where you can make a real impact while maintaining work-life balance, this is it!

What You’ll Do:

Conduct comprehensive MS-DRG and APR-DRG coding reviews to ensure accuracy in DRG assignment and reimbursement.

Apply expert knowledge of coding guidelines and utilize industry-leading tools to maximize overpayment identifications.

Craft clear, concise, and well-supported audit findings, backed by AHA Coding Clinic Guidelines and ICD-10-CM/PCS regulations.

Utilize advanced DRG encoder tools (such as 3M, Webstrat) to drive efficiency and accuracy in audits.

Meet or exceed EXL’s quality and productivity standards, including strong uphold rates for appeals.

Stay ahead of industry trends, coding updates, and compliance regulations to maintain expert-level knowledge.

Adhere to HIPAA and EXL policies and procedures to ensure data security and regulatory compliance.

What We’re Looking For:

• Minimum High School Diploma (Higher education preferred).
• CCS, RHIA, or RHIT credential (Multiple credentials preferred).

Experience & Expertise:

• 4+ years of MS-DRG/APR-DRG coding experience with a deep understanding of AHA Coding Guidelines and DRG reimbursement methodologies.
• Prior experience in DRG retrospective overpayment identification auditing is highly desirable.
• Strong proficiency with DRG encoder tools (3M, Webstrat).

Expert-level inpatient coding knowledge with an in-depth understanding of ICD-10-CM/PCS coding guidelines.

Self-motivated and able to work independently in a remote environment while maintaining high performance.

Exceptional time management, problem-solving, and analytical skills.

Strong written and verbal communication with attention to detail.

Proficient in Excel, Word, and OneNote, with strong overall computer literacy.

Passion for DRG auditing and a commitment to teamwork, collaboration, and continuous learning.

What We Offer:

A fast-paced, innovative environment with a team of industry-leading experts.

Hands-on experience with top-tier clients in the healthcare industry.

Mentorship and career development programs to help you grow professionally.

A strong culture of collaboration, support, and inclusivity.

Competitive benefits package, including healthcare, vision, dental, and 401(k) options.

Ready to Take Your Career to the Next Level?

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider

• Industries

  Hospitals and Health Care

Referrals increase your chances of interviewing at EXL Health by 2x

Inferred from the description for this job

Medical insurance

Vision insurance

401(k)

Paid maternity leave

Paid paternity leave

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