Inpatient DRG Quality Auditor

Humana; New Orleans (LA); Remote; USD 75,000 - 89,000; Full time

Job summary

A leading healthcare services company is seeking a Coding Auditor to conduct quality reviews and drive process improvements. This role offers 100% remote work flexibility and a comprehensive benefits package, including a competitive salary and bonus incentives. Ideal candidates will have extensive DRG coding and auditing experience, along with a medical coding certification. Join a Fortune 100 company dedicated to associate engagement and professional development.

Benefits

Comprehensive benefits package

Medical, dental, vision

401(k)

Generous paid time off

Professional development opportunities

100% remote work flexibility

Qualifications

• Minimum 7 years of DRG coding experience.
• At least 5 years of quality auditing experience.

Responsibilities

• Conduct quality reviews of coding processes focusing on DRG audits.
• Drive process improvement initiatives and develop educational materials.
• Analyze complex issues requiring in-depth evaluation.

Skills

Critical Thinking

Process Improvement

Education

Medical Coding Certification from AHIMA

Job description

Employer Industry: Healthcare Services

Why consider this job opportunity:
- Salary up to $88,600 per year
- Eligible for a bonus incentive plan based on company and individual performance
- Comprehensive benefits package including medical, dental, vision, 401(k), and generous paid time off
- Focus on associate engagement and well-being within a Fortune 100 company
- Opportunity for professional development and continued education
- 100% remote work flexibility

What to Expect (Job Responsibilities):
- Conduct quality reviews of coding processes within the Claims Cost Management organization, focusing on DRG audits
- Drive process improvement initiatives and develop educational materials
- Analyze complex issues requiring in-depth evaluation of variable factors
- Handle provider disputes in a result-oriented and metrics-driven environment
- Manage multiple projects while maintaining attention to detail

What is Required (Qualifications):
- Minimum of 7 years of DRG coding experience
- At least 5 years of quality auditing experience
- Medical coding certification from AHIMA (RHIT, CCS, CICA, CHCA)
- Proven experience reading and coding from medical records
- Strong critical thinking skills and ability to manage diverse priorities independently

How to Stand Out (Preferred Qualifications):
- Experience with CAS, MOATS, and FR
- Background in process improvement
- Multi-specialty auditing experience

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