Remote DRG Coding Auditor – MS/APR-DRG Expert

Elevance Health, Inc.; Stati Uniti; Remoto; USD 93.000 - 160.000; Tempo pieno

Descrizione del lavoro

Elevance Health, Inc. seeks a DRG Coding Auditor to audit inpatient records, validate DRG assignments, and deliver high-quality recoveries. The role emphasizes clinical review, coding accuracy, and collaboration with hospital coding teams.

Hybrid/remote work is available with in-person training sessions required. Ideal candidates have 5+ years in claims auditing and certifications such as RHIA/RHIT/CCS/CIC/CCDS, plus MS-DRG/APR-DRG experience.

Competenze

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

Mansioni

• Audits inpatient medical records and generates recoverable claims for all lines of business.
• Performs clinical reviews of medical records to evaluate DRG assignment accuracy.
• Draws on ICD-10 coding expertise and clinical guidelines to substantiate audit conclusions.
• Uses audit tools and workflow systems to generate audit findings letters.

Conoscenze

ICD-10 coding

Auditing

Clinical review

Quality assurance

Formazione

AA/AS degree

RHIA certification

RHIT certification

CCS certification

CIC certification

CCDS certification

Descrizione del lavoro

Elevance Health, Inc. seeks a DRG Coding Auditor to audit inpatient records, validate DRG assignments, and deliver high-quality recoveries. The role emphasizes clinical review, coding accuracy, and collaboration with hospital coding teams.

Hybrid/remote work is available with in-person training sessions required. Ideal candidates have 5+ years in claims auditing and certifications such as RHIA/RHIT/CCS/CIC/CCDS, plus MS-DRG/APR-DRG experience.