Registered Nurse

Insight Global

United States

Remote

USD 95,000 - 120,000

Full time

14 days+

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Benefits offered by this job

Medical insurance

Vision insurance

401(k)

22 days of PTO

10 paid holidays

Job summary

A leading company is hiring DRG Auditors to work remotely, requiring a current RN, LPN, or BSN. The role involves auditing inpatient medical records and ensuring coding accuracy, with a competitive salary and opportunities for bonuses. Ideal candidates will have extensive knowledge of medical billing systems and coding guidelines.

Qualifications

Experience in clinical documentation (2 years).
Expert coding knowledge in DRG & ICD-10.

Responsibilities

Auditing inpatient medical records for coding accuracy.
Generating high-quality recoverable claims.
Maintaining production goals and quality standards.

Skills

ICD-9/10CM

MS-DRG

AP-DRG

APR-DRG

Medical claims billing

Payer reimbursement policies

Coding terminology

Clinical documentation

Education

Registered Nurse (RN)

Coding/clinical documentation certification

Job description

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

Base pay range

$95,000.00/yr - $120,000.00/yr

Direct message the job poster from Insight Global

NOW HIRING DRG AUDITORS - MUST HAVE CURRENT RN, LPN, OR BSN

**Current coding certification OR ability to get certification prior to starting**

Position: DRG Auditor

Salary: 95K (paid hourly - 45.67/hour) with opportunity for $200-$400 bonuses weekly – Most candidates make $100-120k depending on your commitment to overtime + bonus eligibility. This role is Monday – Friday, NO WEEKENDS. 22 days of PTO with 10 paid holidays

Day to Day

Insight Global is seeking a DRG Validation Auditor for one of our clients to sit 100% remote. This person should have an extensive background in either facility-based nursing, clinical documentation, and/or inpatient coding and has a high level of understanding of reimbursement guidelines specifically an understanding of the MS-DRG, AP-DRG, and APR-DRG payment systems. This position is responsible for auditing inpatient medical records and generating high-quality recoverable claims for the benefit of our client and their clients. They are responsible for performing clinical reviews of medical records and other documentation to evaluate issues of coding and DRG assignment accuracy. Below are the key responsibilities for this role:

Integrates medical chart coding principles, clinical guidelines, and objectivity in the performance of medical audit activities. Draws on advanced ICD-10 coding expertise, clinical guidelines, and industry knowledge to substantiate conclusions. Performs work independently.
Utilizes the clients proprietary auditing systems with a high level of proficiency to make audit determinations and generate audit letters.
Maintains production goals set by the audit operations management team.
Achieves the expected level of accuracy and quality set by the audit for the auditing concept, for valid claim identification and documentation (letter writing).
Identifies potential claims outside of the concept where additional recoveries may be available. Suggests and develops high-quality, high-value concepts and or process improvement, tools, etc.

Must Haves

Experience working with ICD-9/10CM, MS-DRG, AP-DRG, and APR-DRG with a broad knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement policies, medical necessity criteria, and coding terminology.
Expert coding knowledge (DRG & ICD-10)
Registered Nurse RN (must be inpatient) WITH coding/clinical documentation certification (2 years in clinical documentation)

Seniority level