Remote DRG Auditor III - MS-DRG & Compliance Expert

EXL; United States; On-site; USD 73,000 - 99,000; Full time

Benefits offered by this job

Healthcare benefits

Vision and dental

401(k) plan

Mentorship program

Job summary

EXL USA Healthcare is seeking a DRG Auditor III for a fully remote role with up to 10% travel. You will conduct comprehensive MS-DRG and APR-DRG coding reviews, apply coding guidelines, and use DRG encoder tools to drive accuracy.

Ideal candidates have 4+ years of MS-DRG/APR-DRG experience, certifications like CCS/CIC/CPC/RHIA/RHIT, and strong analytical and communication skills. This position offers competitive benefits and opportunities to grow within a dynamic team.

Qualifications

• 4+ years MS-DRG/APR-DRG coding experience with knowledge of AHA Guidelines and DRG reimbursement
• Experience in DRG retrospective overpayment auditing is desirable
• Proficient with DRG encoder tools (3M, Webstrat)

Responsibilities

• Conduct comprehensive MS-DRG and APR-DRG coding reviews for accurate reimbursement.
• Apply coding guidelines and utilize tools to maximize overpayment identifications.
• Draft clear audit findings per ICD-10-CM/PCS regulations and AHA guidelines.
• Utilize DRG encoder tools to improve audit efficiency and accuracy.
• Meet EXL quality and productivity standards, including high appeal uphold rates.
• Stay updated on coding updates and regulatory changes.
• Adhere to HIPAA and EXL policies for data security and compliance.

Skills

Inpatient coding

ICD-10-CM/PCS

Remote work

Time management

Analytical skills

Communication

Education

High School Diploma

CCS, CIC, CPC, RHIA, or RHIT credentials

Tools

3M Encoder

Webstrat

Job description

EXL USA Healthcare is seeking a DRG Auditor III for a fully remote role with up to 10% travel. You will conduct comprehensive MS-DRG and APR-DRG coding reviews, apply coding guidelines, and use DRG encoder tools to drive accuracy.

Ideal candidates have 4+ years of MS-DRG/APR-DRG experience, certifications like CCS/CIC/CPC/RHIA/RHIT, and strong analytical and communication skills. This position offers competitive benefits and opportunities to grow within a dynamic team.