Remote DRG Coding Auditor: MS-DRG & APR-DRG Expert

ANTHEM INSURANCE COMPANIES INC; Severn (MD); Remote; USD 93,000 - 160,000; Full time

Job summary

ANTHEM INSURANCE COMPANIES INC is seeking a DRG Coding Auditor to audit inpatient medical records and generate high quality recoverable claims across lines of business. The role emphasizes DRG assignment accuracy, medical record reviews, and physician statement evaluation, with a focus on MS-DRG, APR-DRG, and AP-DRG coding.

The position supports full-time remote work with required in-person training and occasional office-based sessions, and offers a sign-on bonus of $1,500.

Qualifications

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

Responsibilities

• Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines and objectivity in the performance of medical audit activities.
• Draws on advanced ICD-10 coding expertise, clinical guidelines, and industry knowledge to substantiate conclusions.
• Utilizes audit tools and auditing workflow systems and reference information to make audit determinations and generate audit findings letters.
• Maintains accuracy and quality standards as set by audit management for auditing concept, valid claim identification, and documentation purposes (e.g., letter writing).

Skills

ICD-10 coding

Medical auditing

Audit tools

Education

AA/AS degree

Job description

ANTHEM INSURANCE COMPANIES INC is seeking a DRG Coding Auditor to audit inpatient medical records and generate high quality recoverable claims across lines of business. The role emphasizes DRG assignment accuracy, medical record reviews, and physician statement evaluation, with a focus on MS-DRG, APR-DRG, and AP-DRG coding.

The position supports full-time remote work with required in-person training and occasional office-based sessions, and offers a sign-on bonus of $1,500.