DRG Revenue Integrity Auditor

The Judge Group; United States; Remote; USD 90,000 - 110,000; Full time

Job summary

Join a leading company as a DRG Revenue Integrity Auditor. This remote position seeks a detail-oriented professional to ensure accurate coding and compliance in inpatient reviews. You'll play a vital role in supporting revenue integrity and coding accuracy, while also participating in training and onboarding. The ideal candidate holds a CCS credential and has substantial experience in an acute care setting.

Benefits

Medical insurance

Vision insurance

401(k)

Qualifications

• MUST HAVE CCS credential from AHIMA.
• Minimum of 5 years of experience in DRG auditing or Clinical Documentation.

Responsibilities

• Conduct inpatient chart reviews to ensure accurate coding.
• Perform DRG validation and quality audits on medical records.
• Maintain confidentiality and adhere to HIPAA standards.

Skills

Analytical skills

Organizational skills

Communication skills

Education

CCS credential from AHIMA

5 years of experience in acute care

Tools

Microsoft Office

EMR systems

Job description

1 day ago Be among the first 25 applicants

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

Base pay range

$90,000.00/yr - $110,000.00/yr

Direct message the job poster from The Judge Group

National Healthcare Recruiting Manager @ The Judge Group | Connecting top healthcare workers with their dream job

Job Title: DRG Revenue Integrity Auditor (Remote)

• MUST HAVE CCS credential from AHIMA
• Assessment is required! Once a name is cleared, candidates will receive an assessment that must be completed and passed within 48 hours to remain under consideration.
• Schedule: Monday to Friday, standard business hours. The auditor will align with the time zone of the facility they are supporting, but will primarily work normal business hours in their own time zone.
• Training: Training will be hands-on through shadowing an experienced employee. This is not a self-paced or module-based training program.

Job Summary:

We are seeking a detail-oriented and experienced DRG Revenue Integrity Auditor to join my client's team. In this role, you will conduct inpatient chart reviews to validate Diagnostic Related Group (DRG) assignments, ensuring accurate and compliant coding that reflects the patient’s true clinical picture. You will play a key role in supporting coding accuracy, clinical documentation integrity (CDI), and overall revenue integrity.

Key Responsibilities:

• Perform DRG validation and quality audits on inpatient medical records.
• Ensure accurate ICD-10-CM/PCS coding, POA indicators, SOI/ROM, HCC capture, and CMI.
• Apply current clinical criteria, including MCG, InterQual, CMS guidelines, NCDs/LCDs, and payer policies.
• Identify and document query opportunities to clarify clinical documentation.
• Maintain high-quality standards in chart reviews and ensure timely completion.
• Stay current with official coding guidelines, coding clinics, and CDI best practices (AHIMA, ACDIS).
• Support training and onboarding of new team members; assist in developing training materials.
• Participate in project data analysis, reporting, and client feedback.
• Maintain confidentiality and adhere to HIPAA and ethical coding standards.
• Meet or exceed productivity and quality benchmarks.
• May assist in auditing client CDI programs, including query reviews and coding analysis.

Required Qualifications:

• CCS credential from AHIMA is required.
• Minimum of 5 years of experience in an acute care setting or with a third-party vendor as a DRG Auditor or Clinical Documentation Specialist (CDS).
• Strong knowledge of ICD-10-CM/PCS coding, DRG validation, and CDI principles.
• Experience with EMR systems and remote work environments.
• Proficiency in Microsoft Office tools (Word, Excel, Outlook, Teams).
• Strong analytical, organizational, and communication skills.
• Ability to manage multiple clients and projects simultaneously with minimal supervision.

Preferred Qualifications:

• Prior experience as a CDI/Coding Auditor is a plus.
• Familiarity with multiple EMR platforms and client systems.
• This is a remote position.
• Must be able to maintain secure access to EMR systems and manage login credentials responsibly.

Additional Information:

• Must maintain professional credentials and participate in continuing education.
• May be required to attend virtual meetings and training sessions.
• Other duties as assigned by management.

Seniority level

• Seniority level

  Associate

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider

• Industries

  Hospitals and Health Care

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Inferred from the description for this job

Medical insurance

Vision insurance

401(k)

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