Senior DRG Coding Auditor — Remote

Elevance Health; Indianapolis (IN); Hybrid; USD 90,000 - 130,000; Full time

Job summary

Elevance Health seeks a Clinical Auditor Principal to audit inpatient medical records using DRG-based methodologies across lines of business. This senior role emphasizes advanced ICD-10 coding, policy compliance, and independent work output.

The position supports hybrid/virtual work with in-person onboarding and regular office presence as needed. Candidates should have RHIA, RHIT, CCS, CIC or CCDS and substantial auditing experience.

Qualifications

• Auditing inpatient medical records with complex DRG methodology.
• Deep knowledge of ICD-10 coding guidelines and clinical documentation.
• Ability to perform autonomous, high-quality audits with minimal supervision.

Responsibilities

• Audit claims using DRG methodologies (APS-DRG, APR-DRG, etc.).
• Identify opportunities for high-value recoveries and process improvements.
• Collaborate with management to refine criteria and training.

Education

AA/AS or 15 years experience

Tools

Audit tools & workflow systems

DRG coding review tools

Job description

Elevance Health seeks a Clinical Auditor Principal to audit inpatient medical records using DRG-based methodologies across lines of business. This senior role emphasizes advanced ICD-10 coding, policy compliance, and independent work output.

The position supports hybrid/virtual work with in-person onboarding and regular office presence as needed. Candidates should have RHIA, RHIT, CCS, CIC or CCDS and substantial auditing experience.