DRGV Auditor II

R1 RCM, Inc.; Chicago (IL); Remote; USD 52,000 - 98,000; Full time

Benefits offered by this job

Annual bonus 5%

Job summary

R1 RCM, Inc. is seeking a DRGV Auditor II to audit inpatient cases for DRG validation and documentation improvement. You will review accounts in proprietary software and client EMR systems, with growth potential into Lead Auditor and Mentor roles.

You will review inpatient charts, justify findings with clear evidence, and reference ICD-10 guidelines and AHIMA standards to ensure compliant coding practices.

Qualifications

• Current AHIMA credentials of RHIA, RHIT, and/or CCS are required.
• 3+ years of ICD-10 auditing and DRG reimbursement experience, with recent acute inpatient auditing experience.

Responsibilities

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

Skills

DRG auditing

ICD-10 auditing

Inpatient auditing

Documentation

Education

RHIA

RHIT

CCS

Tools

Proprietary software

EMR systems

Job description

Remote, USA

Full time

R260000006856

R1 is the leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry’s most advanced technology platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration.

As our DRGV Auditor II, 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. Opportunity for growth includes a client facing Lead Auditor role and an internally facing Mentor role.

Every day in this role you will:

• Review inpatient medical records for validation of DRG assignment

• Provide detailed rationale and supporting evidence for 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 auditing and DRG reimbursement experience, with recent acute inpatient auditing experience

For this US-based position, the base pay range is $52,025.00 - $97,528.69 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%

The healthcare system is always evolving — and it’s up to us to use our shared expertise to find new solutions that can keep up. On our growing team you’ll find the opportunity to constantly learn, collaborate across groups and explore new paths for your career.

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. (http://go.r1rcm.com/benefits)

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.

To learn more, visit: R1RCM.com

Visit us on Facebook (https://www.facebook.com/R1RCM)

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 .