Remote DRG Audit Lead — MS/APR-DRG & Compliance

Ex; United States; Remote; USD 100,000 - 120,000; Full time

Job summary

Ex offers a DRG Manager role that leads planning, coordination, and execution of DRG audit activities, ensuring client SLAs and operational goals are met. This role directs a team of auditors responsible for MS-DRG and APR-DRG reviews to assure accurate coding and reimbursement outcomes.

Ideal candidates demonstrate strong leadership and analytical skills, with expertise in Coding Guidelines, Coding Clinic, and audit tools, and a solid understanding of CMS regulations and payer requirements.

Qualifications

• Strong leadership and analytical skills are required.
• Expertise in Coding Guidelines and Coding Clinic.
• Experience with audit tools and CMS/payer requirements.

Responsibilities

• Lead planning, coordination and execution of DRG audit activities.
• Oversee inventory, aging, risks and day-to-day performance.
• Direct a team of auditors responsible for MS-DRG and APR-DRG reviews.
• Collaborate cross-functionally to support program success.

Skills

Leadership

Analytical skills

Coding guidelines

Audit tools

CMS regulations

Payer requirements

Tools

MS-DRG reviews

APR-DRG reviews

Coding Clinic

Job description

Ex offers a DRG Manager role that leads planning, coordination, and execution of DRG audit activities, ensuring client SLAs and operational goals are met. This role directs a team of auditors responsible for MS-DRG and APR-DRG reviews to assure accurate coding and reimbursement outcomes.

Ideal candidates demonstrate strong leadership and analytical skills, with expertise in Coding Guidelines, Coding Clinic, and audit tools, and a solid understanding of CMS regulations and payer requirements.