Remote DRG Coding Auditor (MS-DRG/APR-DRG)

Elevancehealth; Chicago (IL); Remote; USD 70,000 - 95,000; Full time

Benefits offered by this job

Comprehensive benefits package

Equity stock purchase

401k contribution

Job summary

Elevance Health is seeking a DRG Coding Auditor to audit inpatient records and drive accurate DRG assignments for all lines of business. The role emphasizes strong ICD-10 coding, clinical validation, and high-quality audit outcomes.

You will analyze medical charts, use audit tools, and generate findings letters. A RHIA/RHIT or CCS/CIC/CCDS certification is preferred, with a minimum of 5 years in claims auditing or related fields.

Qualifications

• AA/AS or 5+ years of claims auditing experience.
• RHIA/RHIT/CCS/CIC/CCDS certifications preferred.
• Experience with DRG coding and clinical validation audits.

Responsibilities

• Audit inpatient medical records and generate high-quality, recoverable claims across lines of business.
• Perform clinical reviews to evaluate coding and DRG assignment accuracy.
• Utilize ICD-10 coding knowledge and auditing tools to substantiate conclusions.
• Identify potential recoveries through DRG review, readmissions, HACs, and related opportunities.
• Suggest process improvements to increase accuracy and efficiency.

Skills

ICD-10 coding

Auditing

Quality assurance

Education

AA/AS in Health Information

Tools

Audit software

Job description

Elevance Health is seeking a DRG Coding Auditor to audit inpatient records and drive accurate DRG assignments for all lines of business. The role emphasizes strong ICD-10 coding, clinical validation, and high-quality audit outcomes.

You will analyze medical charts, use audit tools, and generate findings letters. A RHIA/RHIT or CCS/CIC/CCDS certification is preferred, with a minimum of 5 years in claims auditing or related fields.