Remote DRG Auditor – Inpatient Coding Expert

Insight Global; South Jordan (UT); On-site; USD 81,000 - 109,000; Full time

Job summary

Insight Global is seeking a DRG Validation Auditor to sit 100% remote. The candidate should have extensive background in facility-based nursing, clinical documentation, and inpatient coding with deep DRG knowledge (MS-DRG, AP-DRG, APR-DRG).

The role involves auditing inpatient records, generating high-quality recoverable claims, and performing clinical reviews to ensure accurate DRG assignments. A strong independent work ethic and advanced coding skills are essential.

Qualifications

• 5-7+ years of experience with ICD-9/10CM and DRG systems including payer guidelines.
• Inpatient RN with coding certification or RHIM/RHIA/RHIT with coding credentials (CCS/CPC)
• Strong knowledge of MS-DRG, AP-DRG and APR-DRG payment systems and guidelines.

Responsibilities

• Audit inpatient medical records to determine accurate DRG assignments and generate audit letters.
• Perform clinical reviews of documentation to assess coding accuracy and compliance.
• Utilize auditing systems to reach production goals and deliver high-quality recoverable claims.
• Identify opportunities for additional recoveries and process improvements.

Skills

ICD-10 coding expertise

MS-DRG/AP-DRG/APR-DRG knowledge

Clinical documentation review

Education

RN inpatient with coding/certification

RHIM/RHIA/RHIT with coding degree or CCS/CPC

Job description

Insight Global is seeking a DRG Validation Auditor to sit 100% remote. The candidate should have extensive background in facility-based nursing, clinical documentation, and inpatient coding with deep DRG knowledge (MS-DRG, AP-DRG, APR-DRG).

The role involves auditing inpatient records, generating high-quality recoverable claims, and performing clinical reviews to ensure accurate DRG assignments. A strong independent work ethic and advanced coding skills are essential.