Inpatient DRG Validation Auditor

R1 RCM, Inc.; United States; On-site; USD 48,000 - 81,000; Full time

Job summary

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

You will use AHIMA guidelines and coding references to justify findings and provide detailed rationale, helping improve accuracy and reimbursement across the revenue cycle.

Qualifications

• 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.
• Current AHIMA credentials of RHIA, RHIT, and/or CCS are required.

Responsibilities

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

Skills

ICD-10 coding and DRG experience

Education

RHIA, RHIT, CCS credentials

Tools

Epic

Cerner

Meditech

Job description

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

You will use AHIMA guidelines and coding references to justify findings and provide detailed rationale, helping improve accuracy and reimbursement across the revenue cycle.