DRG Associate Auditor — Inpatient Coding Expert

R1 RCM, Inc.; Oregon; Hybrid; USD 29,000 - 44,000; Full time

Job summary

R1 RCM Inc. is seeking a DRG Associate Auditor (Analyst) to validate coding updates affecting DRG on claims and to educate on coding compliance for clients. You will evaluate opportunities, document evidence-based recommendations, and pre-screen cases for the DRG Validation Auditing Team.

The role requires recent acute inpatient coding experience and AHIMA credentials (RHIA, RHIT, or CCS). Proficiency with EMR systems like Epic, Cerner, and Meditech is essential.

Qualifications

• Four or more years of ICD-10 coding and DRG reimbursement experience.
• Recent acute inpatient coding experience.
• Current AHIMA credential (RHIA, RHIT, or CCS).
• Experience with multiple EMR systems: Epic, Cerner, Meditech.

Responsibilities

• Validate coding updates that will impact the Diagnosis-Related Group on a claim and may lead to additional reimbursement or coding compliance education for the client.
• Provide detailed rationale and supporting evidence for recommendations.
• Utilize industry-recognized references to support findings.
• Audit a specific rule set and pre-screen opportunities for the DRG Validation Auditing Team.

Skills

ICD-10 coding

DRG reimbursement

Verbal & written communication

Team collaboration

Education

AHIMA credential (RHIA, RHIT, or CCS)

Tools

Epic

Cerner

Meditech

Job description

R1 RCM Inc. is seeking a DRG Associate Auditor (Analyst) to validate coding updates affecting DRG on claims and to educate on coding compliance for clients. You will evaluate opportunities, document evidence-based recommendations, and pre-screen cases for the DRG Validation Auditing Team.

The role requires recent acute inpatient coding experience and AHIMA credentials (RHIA, RHIT, or CCS). Proficiency with EMR systems like Epic, Cerner, and Meditech is essential.