Diagnosis-Related Group (DRG) Manager

EXL Talent Acquisition Team; United States; Remote; USD 100,000 - 120,000; Full time

Job summary

EXL Talent Acquisition Team is seeking a DRG Manager to lead DRG audit activities, ensuring client SLAs and operational goals are met. You will manage a team of auditors handling MS‑DRG and APR‑DRG reviews, with strong CMS and payer requirements knowledge.

The role emphasizes leadership, analytical skills, and collaboration across functions to support program success in a fully remote US-based environment.

Qualifications

• Experience leading DRG audit teams.
• Expertise in CMS regulations and payer requirements.
• Strong leadership and analytical skills.
• Knowledge of MS-DRG and APR-DRG coding practices.

Responsibilities

• Lead planning, coordination, and execution of DRG audit activities.
• Ensure audits meet client SLAs and operational goals.
• Oversee inventory, aging, and risk management.
• Collaborate cross-functionally to support program success.

Skills

Leadership

Auditing

Data analysis

Healthcare coding knowledge

Education

Certified coding specialist (CCS) or equivalent

Tools

Coding Guidelines

Coding Clinic

Audit tools

CMS payer portals

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