Remote DRG Audit Team Lead

Emploive; Northern (KY); Hybrid; USD 100,000 - 110,000; Full time

Benefits offered by this job

Fully remote opportunity with travel ~

Medical, dental, vision, life, and ADP

401K with company match

Flex Time Off

Up to 14 weeks parental leave

Pet insurance

Job summary

Cohere Health is seeking a Team Lead, Auditing for its Payment Integrity group. You will lead a remote team of auditors (Inpatient, Outpatient, Professional), conduct comprehensive reviews to ensure claim accuracy and maximize overpayment identifications.

Preferred credentials include RHIA, RHIT or CCS with deep knowledge of inpatient, outpatient and professional audits, ICD-10-CM/PCS, and HIPAA compliance in a fast-growth setting.

Qualifications

• 8+ years MS-DRG/ARP-DRG reviews for a Payment Integrity vendor or payer.
• 2-3 years supervisory/remote management experience.
• Advanced ICD-10-CM/PCS coding expertise and professional judgment.
• Clear, well-supported audit findings referencing coding sources.

Responsibilities

• Lead and mentor auditors, manage workload and development.
• Collaborate cross-functionally on production, quality and timelines.
• Conduct comprehensive coding reviews for accuracy and reimbursement.
• Utilize DRG tools to maximize overpayment identifications.
• Maintain HIPAA compliance and stay current with coding guidelines.

Skills

Auditing leadership

Team management

Data analysis

Regulatory knowledge

Education

RHIA

RHIT

CCS

Associate's Degree in HIM

Tools

DRG encoder tools

AHA Coding Clinic

ICD-10-CM/PCS

CMS NCDs/LCDs

Job description

Cohere Health is seeking a Team Lead, Auditing for its Payment Integrity group. You will lead a remote team of auditors (Inpatient, Outpatient, Professional), conduct comprehensive reviews to ensure claim accuracy and maximize overpayment identifications.

Preferred credentials include RHIA, RHIT or CCS with deep knowledge of inpatient, outpatient and professional audits, ICD-10-CM/PCS, and HIPAA compliance in a fast-growth setting.