Remote DRG Coding Auditor — MS/APR-DRG Expert

DaMar Staffing; New York (NY); On-site; USD 93,000 - 160,000; Full time

Job summary

Elevance Health seeks a DRG Coding Auditor to audit inpatient records and generate high-quality recoverable claims for all lines of business. You will perform clinical reviews to assess coding accuracy and DRG assignments, specializing in DRG coding via medical records and physician statements from acute care hospitals.

You will analyze claims, utilize ICD-10 coding guidelines, and contribute to audit findings letters.

Qualifications

• Requires AA/AS or 5+ years of claims auditing experience.
• Certifications: RHIA, RHIT, CCS, CIC or CCDS preferred.
• 5 years of experience with ICD-9/10CM, MS-DRG, AP-DRG and APR-DRG.

Responsibilities

• Audits inpatient medical records and generates high quality recoverable claims for the company and clients.
• Performs clinical reviews to evaluate coding and DRG assignment accuracy.
• Specializes in DRG coding review via medical records and attending physician statements from acute care hospitals.
• Identifies new claim types and suggests process improvements for higher recoveries.

Skills

ICD-10 coding

Auditing

Medical chart review

Education

AA/AS degree

RHIA

RHIT

CCS

CIC

CCDS

BA/BS preferred

Tools

MS-DRG

AP-DRG

APR-DRG

ICD-9/10CM

Job description

Elevance Health seeks a DRG Coding Auditor to audit inpatient records and generate high-quality recoverable claims for all lines of business. You will perform clinical reviews to assess coding accuracy and DRG assignments, specializing in DRG coding via medical records and physician statements from acute care hospitals.

You will analyze claims, utilize ICD-10 coding guidelines, and contribute to audit findings letters.