Remote Inpatient DRG Auditor — Acute Care

Elevance Health; Butlerville (IN); A distancia; USD 95.000 - 150.000; Jornada completa

Descripción de la vacante

Elevance Health is seeking an Inpatient DRG Validator (Acute Care) to audit inpatient records and generate high quality recoverable claims across all lines of business. You will apply ICD-10 coding expertise and clinical guidelines to validate DRG assignments.

The role uses audit tools and workflows to make determinations, draft audit letters, and identify opportunities for additional recoveries. Remote work is supported with required in-person training.

Formación

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

Responsabilidades

• Audit claims using medical coding principles and guidelines.
• Apply ICD-10 coding expertise to validate DRG assignments.
• Use audit tools to generate findings letters and document results.
• Identify new claim types for potential recoveries and improvements.

Conocimientos

ICD-10 coding

Auditing

Healthcare claims

Educación

AA/AS degree

RHIA/RHIT/CCS/CIC certifications

Herramientas

ICD-9/10CM

MS-DRG

AP-DRG

APR-DRG

Descripción del empleo

Elevance Health is seeking an Inpatient DRG Validator (Acute Care) to audit inpatient records and generate high quality recoverable claims across all lines of business. You will apply ICD-10 coding expertise and clinical guidelines to validate DRG assignments.

The role uses audit tools and workflows to make determinations, draft audit letters, and identify opportunities for additional recoveries. Remote work is supported with required in-person training.