Remote Inpatient DRG Validator (Acute Care)

Elevance Health; Florida; Hybrid; USD 95,000 - 150,000; Full time

Benefits offered by this job

Hybrid work model

Comprehensive benefits package

401(k) + match

Job summary

Elevance Health is seeking an Inpatient DRG Validator (Acute Care) to audit inpatient records and validate DRG coding across multiple lines of business. The role emphasizes high-quality recoverable claims and clinical review of documentation.

The position supports hybrid/remote work with required in-person training and potential location-based considerations. A comprehensive benefits package is included and the role emphasizes adherence to coding guidelines and performance standards.

Qualifications

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

Responsibilities

• Audit inpatient medical records and DRG coding accuracy.
• Perform clinical reviews to evaluate coding and DRG assignment.
• Develop audit findings letters and communicate results.
• Identify opportunities for high-value process improvements.

Skills

DRG coding knowledge

Auditing experience

Medical chart review

Education

AA/AS

BA/BS preferred

Tools

RHIA

RHIT

CCS

CIC

Job description

Elevance Health is seeking an Inpatient DRG Validator (Acute Care) to audit inpatient records and validate DRG coding across multiple lines of business. The role emphasizes high-quality recoverable claims and clinical review of documentation.

The position supports hybrid/remote work with required in-person training and potential location-based considerations. A comprehensive benefits package is included and the role emphasizes adherence to coding guidelines and performance standards.