Remote Inpatient DRG Validator – Acute Care

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

Benefits offered by this job

Remote work option

In-person training

Job summary

Elevance Health is seeking an Inpatient DRG Validator (Acute Care) to audit inpatient records and generate high quality, recoverable claims across lines of business. The role emphasizes ICD-10 coding accuracy and clinical review of DRG assignments in acute care hospitals.

The position requires 5+ years of auditing experience with DRG frameworks and may include hybrid/remote work with in-person training sessions. A comprehensive benefits package is offered.

Qualifications

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

Responsibilities

• Audits inpatient records and generates high quality recoverable claims.
• Performs clinical reviews to evaluate DRG coding accuracy.
• Uses audit tools and workflow systems to issue audit findings letters.
• Identifies new claim types for additional recoveries and process improvements.

Skills

ICD-10 coding expertise

Medical record auditing

Quality assurance

Clinical review

Education

AA/AS degree

5+ years claims auditing experience

Tools

Audit tools

Job description

Elevance Health is seeking an Inpatient DRG Validator (Acute Care) to audit inpatient records and generate high quality, recoverable claims across lines of business. The role emphasizes ICD-10 coding accuracy and clinical review of DRG assignments in acute care hospitals.

The position requires 5+ years of auditing experience with DRG frameworks and may include hybrid/remote work with in-person training sessions. A comprehensive benefits package is offered.