DRG-V Auditor I

R1 RCM Holdco Inc.; Illinois; Hybrid; USD 48,000 - 81,000; Full time

Benefits offered by this job

Annual bonus

Competitive benefits

Job summary

R1 RCM Inc. is seeking a DRG Validation Auditor I to audit inpatient cases for DRG validation and documentation improvement. You will review accounts in proprietary software and client EMR systems to validate the accounts.

Daily tasks include reviewing records for DRG validation, providing detailed rationale with evidence, and citing ICD-10 guidelines. Candidates should have AHIMA credentials (RHIA, RHIT, CCS) and 3+ years of acute inpatient auditing experience with Epic, Cerner, or Meditech.

Qualifications

• Current AHIMA credentials RHIA, RHIT, and/or CCS are required.
• 3+ years of ICD-10 coding and DRG reimbursement experience, with recent acute inpatient auditing experience.
• Experience with multiple EMR systems such as Epic, Cerner, and Meditech.

Responsibilities

• Review inpatient medical records for validation of DRG assignment.
• Provide detailed rationale and supporting evidence for the recommendation and findings.
• Utilize industry-recognized references to support review findings (ICD-10 Guidelines, AHIMA Standards, AHIMA Practice Briefs, AHA Coding Clinics).

Skills

ICD-10 coding

DRG reimbursement

Education

RHIA

RHIT

CCS

Tools

Epic

Cerner

Meditech

Job description

We are a leading provider of technology-driven solutions that transform the patient experience and financial performance of healthcare providers. We deliver proven ROI across the entire revenue cycle – front, middle, and back office. This enables our customers to achieve an optimal revenue cycle – one that promotes patient satisfaction and improves financial performance.

As our DRG Validation Auditor I, your primary role will be auditing inpatient cases for DRG validation and/or documentation improvement. This consists of reviewing accounts in proprietary software and client EMR systems to validate the accounts.

Every day in this role, you will:

• Review inpatient medical records for validation of DRG assignment
• Provide detailed rationale and supporting evidence for the recommendation and findings
• Utilize industry-recognized references to support their review findings, such as the ICD-10 Official Guidelines for Coding and Reporting, AHIMA Standards of Ethical Coding, AHIMA Practice Briefs related to compliant querying, and AHA Coding Clinics

To succeed in this role, you must have:

• Current AHIMA credentials of one or more of the following are required: RHIA, RHIT, and/or CCS
• 3+ years of ICD-10 coding and DRG reimbursement experience, with recent acute inpatient auditing experience
• Experience with multiple EMR Systems such as Epic, Cerner, and Meditech

For this US-based position, the base pay range is $48,131.00 - $81,225.49 per year. Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training. This job is eligible to participate in our annual bonus plan at a target of 5.00%.

Our associates are given the chance to contribute, think boldly and create meaningful work that makes a difference in the communities we serve around the world. We go beyond expectations in everything we do. Not only does that drive customer success and improve patient care, but that same enthusiasm is applied to giving back to the community and taking care of our team — including offering a competitive benefits package.

R1 RCM Inc. (“the Company”) is dedicated to the fundamentals of equal employment opportunity. The Company’s employment practices, including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person’s age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, the Company is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories.

If you have a disability and require a reasonable accommodation to complete any part of the job application process, please contact us at 312-496-7709 for assistance.

CA PRIVACY NOTICE: California resident job applicants can learn more about their privacy rights California Consent To learn more, visit: R1RCM.com Visit us on Facebook R1 is the leader in healthcare revenue management, helping providers achieve new levels of performance through smart orchestration. A pioneer in the industry, R1 created the first Healthcare Revenue Operating System: a modular, intelligent platform that integrates automation, AI, and human expertise to strengthen the entire revenue cycle. With more than 20 years of experience, R1 partners with 1,000 providers, including 95 of the top 100 U.S. health systems, and handles over 270 million payer transactions annually. This scale provides unmatched operational insight to help healthcare organizations unlock greater long-term value. To learn more, visit: https://www.r1rcm.com.