Remote DRG Validation Auditor I

R1 RCM, Inc.; Chicago (IL); Remote; USD 48,000 - 81,000; Full time

Benefits offered by this job

Annual bonus 5%

Job summary

R1 RCM Inc. is a leading provider delivering technology-driven solutions to transform the patient experience and healthcare revenue performance.

As a DRG Validation Auditor I, you will audit inpatient cases for DRG validation and documentation improvement, reviewing accounts in proprietary software and client EMR systems. Daily tasks include reviewing records for DRG assignment, providing detailed rationale with evidence, and using references such as ICD-10 Official Guidelines, AHIMA Standards,

Qualifications

• Current AHIMA credentials (RHIA/RHIT/CCS) required.
• 3+ years of ICD-10 coding and DRG reimbursement experience, with recent acute inpatient auditing experience.
• Experience with multiple EMR Systems such as Epic, Cerner, and Meditech.

Responsibilities

• Review inpatient medical records for validation of DRG assignment.
• Provide detailed rationale and supporting evidence for recommendations and findings.
• Utilize industry references (ICD-10 Guidelines, AHIMA Standards, AHIMA Practice Briefs, AHA Coding Clinics) to support reviews.

Skills

Auditing

ICD-10 coding

DRG reimbursement

Education

AHIMA credentials (RHIA/RHIT/CCS)

Tools

Epic EMR

Cerner EMR

Meditech EMR

Job description

R1 RCM Inc. is a leading provider delivering technology-driven solutions to transform the patient experience and healthcare revenue performance.

As a DRG Validation Auditor I, you will audit inpatient cases for DRG validation and documentation improvement, reviewing accounts in proprietary software and client EMR systems. Daily tasks include reviewing records for DRG assignment, providing detailed rationale with evidence, and using references such as ICD-10 Official Guidelines, AHIMA Standards,