Diagnosis-Related Group (DRG) Manager

ExlService Holdings, Inc.; Northern (KY); Hybrid; USD 100,000 - 120,000; Full time

Benefits offered by this job

Remote work (US-based)

Travel up to 10%

Job summary

ExlService Holdings, Inc. is seeking a DRG Manager to lead the planning, coordination, and execution of DRG audit activities, ensuring teams meet client SLAs and operational goals.

You will manage a team of auditors responsible for MS-DRG and APR-DRG reviews, ensuring accurate coding and reimbursement outcomes, while applying Coding Guidelines and CMS regulations. This role offers 100% remote work for US-based candidates, with up to 10% travel for team meetings and limited client onsite

Qualifications

• Experience leading DRG audits and teams.
• Strong knowledge of MS-DRG and APR-DRG reviews.
• Familiarity with Coding Guidelines and Coding Clinic.

Responsibilities

• Lead DRG audit activities and ensure client SLAs.
• Directly manage a team of auditors for DRG reviews.
• Collaborate across functions to support program success.

Skills

Leadership

Auditing

CMS regulations

Coding Guidelines

Analytical skills

Tools

Audit tools

Job description

The DRG Manager leads the planning, coordination, and execution of DRG audit activities, ensuring teams meet client SLAs and operational goals. This role oversees inventory, aging, risks, and day-to-day performance, while collaborating cross-functionally to support program success.

The role directly manages a team of auditors responsible for MS-DRG and APR-DRG reviews, ensuring accurate coding and reimbursement outcomes. The ideal candidate demonstrates strong leadership and analytical skills, along with expertise in Coding Guidelines, Coding Clinic, and audit tools, and a solid understanding of CMS regulations and payer requirements.

Salary Range: $100,000 – $120,000(based on experience, skills, and qualifications)
Location: 100% Remote (U.S.-based)

Up to 10% annual travel(for team meetings and limited client onsite engagements.)

A brief coding/auditing assessment may be included as part of the interview process.

For more information on benefits and what we offer please visit us at https://www.exlservice.com/us-careers-and-benefits