10 drg coding auditor jobs found in Chicago

DRG Coding Auditor Principal This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered. Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. The DRG Coding Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) methodology, including case rate and per diem, generating highly complex audit findings recoverable claims for the benefit of the Company, for all lines of business, and its clients. Specializes in review of DRG coding via medical record and attending...

DRG Coding Auditor Principal This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. The DRG Coding Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) methodology, including case...

Anticipated End Date: 2026-01-05 Position Title: Diagnosis Related Group Clinical Validation Auditor (CDI, MS-DRG, AP-DRG and APR-DRG) Job Description: Be Part of an Extraordinary Team Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical‑expense spending. Build the Possibilities. Make an Extraordinary Impact. Title: Diagnosis Related Group Clinical Validation Auditor (CDI, MS-DRG, AP-DRG and APR-DRG) Virtual: This role enables associates to work virtually full‑time, with the exception of required in‑person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work‑life integration, and ensures essential face‑to‑face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the...

DRG Coding Auditor Principal Virtual: This role enables associates to work virtually full‑time, with the exception of required in‑person training sessions, providing maximum flexibility and autonomy. All candidates must be within a reasonable commuting distance from the posting location(s) unless an accommodation is required by law. Responsibilities Analyzes and audits claims by integrating advanced coding principles from the Official Coding Guidelines, Coding Clinics, and the ICD‑10 Alphabetic and Tabular Indices, complex clinical guidelines, and maintains objectivity in all audit activities. Draws on advanced ICD‑10 coding expertise, clinical guidelines, and industry knowledge to substantiate sophisticated conclusions. Utilizes audit tools, workflow systems, and reference information to make audit determinations and generate audit findings letters. Validates accuracy and quality standards as set by audit management for the auditing concept, valid claim identification, and...

DRG Coding Auditor Principal Virtual: _ This role enables associates to work virtually full-time, with the exception of required in‑person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work‑life integration, and ensures essential face‑to‑face onboarding and skill development. Alternate locations may be considered. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical‑expense spending. The DRG Coding Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) methodology,...

A prominent health company seeks a DRG Coding Auditor Principal to audit medical records and claims based on DRG methodology. The role requires advanced coding expertise and the ability to work independently. Candidates must have significant experience in claims auditing and relevant health information certifications. This position offers the flexibility of a virtual work environment, promoting work-life integration, while ensuring professional growth and comprehensive benefits. #J-18808-Ljbffr

Job Description Be a part of a world‑class academic healthcare system at UChicago Medicine as a Coding Auditor - DRG/APC Coordinator for the Health Information Management department. This is a remote, work from home opportunity and you may be based outside of the greater Chicagoland area. In this role, the Coding Auditor - DRG/APC Coordinator is responsible for ensuring accuracy and quality of coding assignments for all records requiring DRG and/or APC coding, and ensures optimal and timely reimbursement. Essential Job Functions Performs data quality reviews on inpatient and outpatient records to ensure proper coding guidelines have been followed and appropriate DRG or APC assignments have been made for appropriate reimbursement Provides DRG/APC and coding quality information and statistical reports to the Coding Manager Communicates with the Medical Staff and House staff as needed to discuss clinical questions with respect to the assignment of ICD-10-CM and...

A prominent medical institution seeks a Coding Auditor - DRG/APC Coordinator to ensure the accuracy and quality of coding assignments for healthcare records. This remote position requires a Bachelor's degree or equivalent, along with RHIT and CCS credentials. Candidates should have at least four years of coding experience, including two years of PPS coding and experience in an academic setting. Responsibilities include conducting data quality reviews, providing reports, and educating medical staff on documentation standards. Join us in advancing healthcare excellence. #J-18808-Ljbffr

Inpatient Medical Coding Auditor page is loaded## Inpatient Medical Coding Auditorlocations: Remote Nationwidetime type: Full timeposted on: Posted Todayjob requisition id: R-397765# **Become a part of our caring community and help us put health first**The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and...

The Senior / Super Coder serves as a high-performing coding professional responsible for the accurate and timely assignment of ICD-10-CM/PCS, CPT, and HCPCS codes for all hospital services including inpatient, outpatient, emergency, surgery, and RHC encounters. This position functions as the department’s top-tier coder and provides advanced coding expertise, mentorship, and support to the Coding Team Leader, enabling her to focus on quality assurance, compliance, and education. The Senior Coder must maintain exceptional accuracy, productivity, and compliance with official coding guidelines, payer requirements, and FMH policy. Key Responsibilities Independently review and abstract complex clinical documentation for accurate code assignment. Assign appropriate ICD-10-CM/PCS, CPT, and HCPCS codes using the 3M encoder across multiple service lines. Resolve coding edits, medical necessity issues, and payer rejections efficiently. Collaborate with providers and the Coding Team...