506 drg coding auditor jobs found

DRG Coding Auditor 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. The DRG Coding Auditor is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines of business, and its clients. Also responsible for performing clinical reviews of medical records and other documentation to evaluate issues of coding and DRG assignment accuracy. Specializes in review of DRG coding via medical record and attending physician's statement sent in by acute care hospitals on submitted DRG. Primary duties may include, but are not limited to: Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines and objectivity in the performance of medical audit...

Join Our 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: DRG Coding Auditor 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 posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Alternate locations may be considered if candidates reside within a commuting distance from an office. The DRG Coding Auditor is...

Overview Be inspired. Be valued. Belong. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide: Comprehensive health benefits that start day 1 Student Loan Repayment Assistance & Reimbursement Programs Family-focused benefits Wellness incentives Ongoing mentorship, development, leadership programs...and more! Description We are seeking an experienced Inpatient DRG Coding Auditor to extract data from patient encounters ensuring the accuracy of DRGs. This individual will: Reviews inpatient medical records for select payer populations post-discharge and pre-bill; audits the accuracy and completeness of diagnosis and procedure coding, DRG assignment, and abstracted data POA, Discharge Disposition. Reviews discrepancies between the Clinical...

A leading health care provider is seeking a DRG Coding Auditor Principal to audit inpatient medical claims using DRG methodologies. The role requires substantial expertise in ICD-10 coding and at least 15 years of auditing experience. You'll work primarily remote, attending in-person training sessions as needed. This position offers a competitive salary ranging from $119,760 to $206,586 and a comprehensive benefits package, promoting a flexible work-life balance. #J-18808-Ljbffr

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. Work Location Policy 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. Job Overview 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...

Registered Nurse - Diagnosis Related Group Coding Auditor Principal – Carelon Payment Integrity Location: Alternate locations may be considered. This position will work in a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations. 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 records and attending physician’s statements provided by acute care hospitals on paid DRG,...

A healthcare company seeks a Diagnosis Related Group Clinical Validation Auditor to audit medical records for coding accuracy, requiring substantial experience and certifications in medical coding. This role allows for virtual work while ensuring compliance with auditing standards and improving efficiency in claims recovery. Ideal candidates have a history in claims auditing and familiarity with DRG processes. Competitive salary range of $95,172 to $149,556 planned for this position. #J-18808-Ljbffr

A healthcare company is hiring a Clinical Review Auditor to perform DRG validation and coding reviews on medical records. This remote role requires a strong understanding of ICD-10 coding, communication skills, and clinical knowledge. Ideal candidates will possess a CCS or CIC certification along with auditing experience. The compensation range is $68,566 to $104,841, along with a comprehensive benefits package. #J-18808-Ljbffr

Overview As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, integrity, quality and trust that are integral to our mission. EO/AA This position audits the accuracy and completeness of diagnosis and procedure coding, DRG assignment, and abstracted data to support that appropriate reimbursement and clinical severity is captured for the level of service rendered. Provides ongoing education to coders, physicians, and other clinical staff. The incumbent serves in an advisory and educator role for coding and regulatory compliance. Corporate Overview: The University of Utah is a Level 1 Trauma Center and is nationally ranked and recognized for its academic...

A health organization in Salt Lake City, Utah is seeking a detail-oriented professional to ensure coding accuracy and compliance. The candidate will be responsible for auditing medical records, educating clinical staff, and participating in coding accuracy initiatives. Required qualifications include a Bachelor's degree, CCS certification, and experience with ICD-10 coding. This role offers an opportunity to contribute to patient care and support high-quality healthcare delivery in a collaborative environment. #J-18808-Ljbffr

A healthcare organization in Salt Lake City is seeking a coding specialist to audit diagnoses and procedure coding while providing education to coders and clinical staff. The ideal candidate will have a Bachelor's degree or relevant experience, along with CCS and CDIP certifications. This role emphasizes collaboration and accuracy in coding compliance, alongside a commitment to improving healthcare services. #J-18808-Ljbffr

A health-focused institution in Salt Lake City is looking for a Coding Auditor to ensure accuracy and compliance in medical coding. The ideal candidate will audit inpatient medical records, enhance coding accuracy, and provide training to coders. Required qualifications include a Bachelor's degree or equivalent HIM management experience, CCS certification, and experience with ICD-10 coding. This position promotes professional growth and collaboration within a dynamic clinical environment. #J-18808-Ljbffr

Inpatient/DRG Validation Coding Auditor The Inpatient/DRG Validation Coding Auditor performs documentation and coding audits for all acute inpatient services for clients. Identifies coding errors, compliance, and educational opportunities, and optimizes reimbursement by ensuring that the diagnosis/procedure codes and supporting documentation accurately support the services rendered and comply with ethical coding standards/guidelines and regulatory requirements. Performs independent reviews, interprets medical records, and applies in-depth knowledge of coding principles to determine billing/coding/documentation issues and quality concerns. Demonstrates high level of expertise in researching requirements necessary to make compliant recommendations. Has an extensive understanding of reimbursement guidelines, specifically related to DRG (MS, APR, Tricare, etc.) payment systems. Conducts DRG (ex. MS, APR, Tricare) coding and clinical reviews to verify the accuracy of coding, DRG...

Inpatient/DRG Validation Coding Auditor The Inpatient/DRG Validation Coding Auditor performs documentation and coding audits for all acute inpatient services for clients. Identifies coding errors, compliance, and educational opportunities, and optimizes reimbursement by ensuring that the diagnosis/procedure codes and supporting documentation accurately support the services rendered and comply with ethical coding standards/guidelines and regulatory requirements. Performs independent reviews, interprets medical records, and applies in-depth knowledge of coding principles to determine billing/coding/documentation issues and quality concerns. Demonstrates high level of expertise in researching requirements necessary to make compliant recommendations. Has an extensive understanding of reimbursement guidelines, specifically related to DRG (MS, APR, Tricare, etc.) payment systems. Conducts DRG (ex. MS, APR, Tricare) coding and clinical reviews to verify the accuracy of coding, DRG...

Inpatient/DRG Validation Coding Auditor The Inpatient/DRG Validation Coding Auditor performs documentation and coding audits for all acute inpatient services for clients. Identifies coding errors, compliance, and educational opportunities, and optimizes reimbursement by ensuring that the diagnosis/procedure codes and supporting documentation accurately support the services rendered and comply with ethical coding standards/guidelines and regulatory requirements. Performs independent reviews, interprets medical records, and applies in-depth knowledge of coding principles to determine billing/coding/documentation issues and quality concerns. Demonstrates high level of expertise in researching requirements necessary to make compliant recommendations. Has an extensive understanding of reimbursement guidelines, specifically related to DRG (MS, APR, Tricare, etc.) payment systems. Conducts DRG (ex. MS, APR, Tricare) coding and clinical reviews to verify the accuracy of coding, DRG...

Inpatient/DRG Validation Coding Auditor The Inpatient/DRG Validation Coding Auditor performs documentation and coding audits for all acute inpatient services for clients. Identifies coding errors, compliance, and educational opportunities, and optimizes reimbursement by ensuring that the diagnosis/procedure codes and supporting documentation accurately support the services rendered and comply with ethical coding standards/guidelines and regulatory requirements. Performs independent reviews, interprets medical records, and applies in-depth knowledge of coding principles to determine billing/coding/documentation issues and quality concerns. Demonstrates high level of expertise in researching requirements necessary to make compliant recommendations. Has an extensive understanding of reimbursement guidelines, specifically related to DRG (MS, APR, Tricare, etc.) payment systems. Conducts DRG (ex. MS, APR, Tricare) coding and clinical reviews to verify the accuracy of coding, DRG...

Inpatient/DRG Validation Coding Auditor The Inpatient/DRG Validation Coding Auditor performs documentation and coding audits for all acute inpatient services for clients. Identifies coding errors, compliance, and educational opportunities, and optimizes reimbursement by ensuring that the diagnosis/procedure codes and supporting documentation accurately support the services rendered and comply with ethical coding standards/guidelines and regulatory requirements. Performs independent reviews, interprets medical records, and applies in-depth knowledge of coding principles to determine billing/coding/documentation issues and quality concerns. Demonstrates high level of expertise in researching requirements necessary to make compliant recommendations. Has an extensive understanding of reimbursement guidelines, specifically related to DRG (MS, APR, Tricare, etc.) payment systems. Conducts DRG (ex. MS, APR, Tricare) coding and clinical reviews to verify the accuracy of coding, DRG...

A healthcare management company in Fort Worth, Texas, is seeking a DRG Quality Control/Clinical Auditor. This remote position involves reviewing medical records for DRG validation, ensuring coding accuracy, and providing clinical support. Candidates should have a minimum of 2 years of auditing experience and relevant certification. The role emphasizes effective communication and strong critical thinking skills, offering a competitive salary range of $68,566 – $104,841. #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 ICD-10-PCS...

A healthcare organization is seeking a Coding & Clinical Auditor / DRG Specialist RN to apply expert knowledge in coding and reimbursement methodologies. This position allows for flexible telecommuting from anywhere in the U.S. The successful candidate will verify DRG assignments, validate codes, and support audit findings with solid analytical skills. Required qualifications include an Associate's Degree, RN license, and experience in hospital coding. A competitive salary and comprehensive benefits package are provided. #J-18808-Ljbffr

A leading healthcare consulting firm is seeking a Clinical Coding Auditor & Trainer to lead DRG and medical record auditing while delivering staff training programs. The role emphasizes quality improvement and compliance across clinical and coding teams. Candidates should have a relevant license and an associate’s degree in nursing, coupled with 4+ years in auditing and at least 1 year of clinical experience. This primarily remote position offers competitive benefits and workplace flexibility. #J-18808-Ljbffr

A leading healthcare company seeks an Inpatient Medical Coding Auditor to extract clinical information from medical records and assign appropriate codes. This remote position requires RHIA, RHIT, or CCS certification, and emphasizes experience with MS-DRG coding. The ideal candidate will handle claims, perform audits, and manage multiple priorities, contributing to accurate provider payments and cost reduction. Join us to make an impact in healthcare while enjoying a flexible work environment. #J-18808-Ljbffr

A leading health insurance provider based in Olympia, WA, is seeking an Inpatient Medical Coding Auditor. The role involves reviewing inpatient hospital claims for proper reimbursement and requires strong qualifications, including RHIA, RHIT, or CCS certification with MS-DRG experience. This remote position allows for flexible work hours and contributes significantly to cost reduction and accuracy in provider payments. Join a company committed to the well-being of its clients and team members. #J-18808-Ljbffr

A leading health insurance company is seeking a qualified Inpatient Medical Coding Auditor to work fully remote in New Jersey. Responsibilities include reviewing inpatient claims for accuracy, ensuring correct payments, and working independently. Candidates should possess an RHIA, RHIT, or CCS certification, along with MS-DRG coding experience. The role offers competitive pay ranging from $71,100 to $97,800 annually, and occasional travel may be required for training and meetings. #J-18808-Ljbffr