Remote Inpatient DRG Auditor III | Coding Expert

EXL; Oregon; Hybrid; USD 73,000 - 99,000; Full time

Benefits offered by this job

Competitive benefits package

Job summary

EXL USA Healthcare is seeking a DRG Auditor III for a fully remote role in the U.S. with up to 10% annual travel. You will conduct MS-DRG/APR-DRG reviews and prepare well-supported audit findings in line with AHA guidelines and ICD-10-CM/PCS regulations.

Required 4+ years of MS-DRG/APR-DRG coding experience and DRG encoder proficiency (3M, Webstrat). Strong communication, time management, and remote-work discipline are essential.

Qualifications

• 4+ years of MS-DRG/APR-DRG coding experience with strong knowledge of AHA Coding Guidelines and DRG reimbursement methodologies.
• Credentials CCS, CIC, CPC, RHIA, or RHIT preferred.
• Proficiency with DRG encoder tools (3M, Webstrat).
• Experience in DRG retrospective overpayment identification auditing is desirable.

Responsibilities

• Conduct MS-DRG and APR-DRG coding reviews to ensure accurate DRG assignment and reimbursement.
• Apply coding guidelines and use tools to maximize overpayment identifications.
• Draft clear audit findings with support from ICD-10-CM/PCS guidelines.
• Use encoder tools (3M, Webstrat) to improve audit efficiency and accuracy.
• Meet EXL quality and productivity standards, including strong uphold rates for appeals.
• Stay updated on coding trends and regulatory changes.
• Adhere to HIPAA and EXL policies for data security.

Skills

Inpatient coding

Remote work independence

Analytical skills

Time management

Communication skills

Education

CCS/CIC/CPC/RHIA/RHIT credentials

High School Diploma

Tools

3M DRG encoder

Webstrat encoder

Excel

Word

OneNote

Job description

EXL USA Healthcare is seeking a DRG Auditor III for a fully remote role in the U.S. with up to 10% annual travel. You will conduct MS-DRG/APR-DRG reviews and prepare well-supported audit findings in line with AHA guidelines and ICD-10-CM/PCS regulations.

Required 4+ years of MS-DRG/APR-DRG coding experience and DRG encoder proficiency (3M, Webstrat). Strong communication, time management, and remote-work discipline are essential.