17 drg coding auditor jobs found in Chicago, IL

Elevance Health is seeking a DRG Coding Auditor to audit inpatient medical records and generate recoverable claims across lines of business, ensuring accurate DRG assignment with MS-DRG and APR-DRG methodologies. You will apply ICD-10 guidelines and clinical documentation principles in medical record reviews, supporting high-quality recoveries and audit findings while collaborating with hospitals and internal teams. The role offers hybrid/remote work with required in-person training. #J-18808-Ljbffr

Elevance Health is seeking a DRG Coding Auditor to review inpatient medical records for accuracy in DRG assignment across all lines of business. This role conducts clinical reviews, supports recovery auditing, and writes audit findings letters to communicate conclusions. The ideal candidate holds RHIA/RHIT/CCS/CIC/CCDS certification or AA/AS with 5+ years of coding and auditing experience, and can work remotely with occasional in-person training sessions as required. #J-18808-Ljbffr

Elevance Health is seeking a DRG Coding Auditor to audit inpatient medical records and generate recoverable claims across lines of business, ensuring accurate DRG assignment with MS-DRG and APR-DRG methodologies. You will apply ICD-10 guidelines and clinical documentation principles in medical record reviews, supporting high-quality recoveries and audit findings while collaborating with hospitals and internal teams. The role offers hybrid/remote work with required in-person training. #J-18808-Ljbffr

Anticipated End Date: 2026-10-12 Position Title: DRG Coding Auditor - MS-DRG and APR-DRG Job Description: Sign On Bonus: $1,500; paid in two installments: $500 at the time of hire and $1,000 after one year of service. DRG Coding Auditor - MS-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 . Alternate locations may be considered if candidates reside within a commuting distance from an office. 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. The DRG Coding Auditor is responsible for auditing inpatient...

Job description Experienced Associate, Healthcare Forensics The Experienced Associate, Healthcare Forensics role is a highly analytical and detail-oriented individual responsible for identifying, analyzing, and resolving payment inaccuracies across healthcare claims as it relates to reimbursement disputes, fraud, waste, and abuse investigation, regulatory compliance, and litigation. The ideal candidate will bring a strong understanding of healthcare reimbursement methodologies, claims data, and regulatory frameworks. The Experienced Associate, Healthcare Forensics demonstrates an investigative mindset with problem solving skills and the ability to think critically about data to deliver high-quality work product for clients. Job Duties: Provides investigation and analysis to a variety of clients, including outside counsel, regulators, and companies involved in litigation, investigation, dispute, regulatory, and compliance matters Contributes to forensic engagements related to...

Coding Quality Auditor and Specialist, HB Coding, Full-time, Days (Remote) At Northwestern Medicine, every patient interaction makes a difference in cultivating a positive workplace. This patient-first approach is what sets us apart as a leader in the healthcare industry. As part of our team, you’ll have the opportunity to contribute to better health care across the Northwestern Medicine system. We offer competitive benefits including tuition reimbursement and loan forgiveness, 401(k) matching, and lifecycle benefits. The Coding Quality Auditor and Specialist reflects the mission, vision, and values of NM, adheres to the organization’s Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and regulatory standards. This role is the expert in clinical documentation and coding, working with the Clinical Documentation Team to ensure quality metrics meet high standards for NM Health System. The Coding Quality Auditor and...

Job description Experienced Associate, Healthcare Forensics The Experienced Associate, Healthcare Forensics role is a highly analytical and detail-oriented individual responsible for identifying, analyzing, and resolving payment inaccuracies across healthcare claims as it relates to reimbursement disputes, fraud, waste, and abuse investigation, regulatory compliance, and litigation. The ideal candidate will bring a strong understanding of healthcare reimbursement methodologies, claims data, and regulatory frameworks. The Experienced Associate, Healthcare Forensics demonstrates an investigative mindset with problem solving skills and the ability to think critically about data to deliver high-quality work product for clients. Job Duties: Provides investigation and analysis to a variety of clients, including outside counsel, regulators, and companies involved in litigation, investigation, dispute, regulatory, and compliance matters Contributes to forensic engagements related to...

Revenue Cycle Coder III-Inpatient Coding Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 158 hospital-based locations, in addition to its home-based services and virtual care offerings. As our Advanced Coding & CDI Educator, you will leverage your expert knowledge in ICD-10-CM, ICD-10-PCS, and CPT-4 coding to drive excellence in our health information management (HIM) department. This critical role focuses on elevating coding accuracy, enhancing Clinical Documentation Improvement (CDI) practices, and ensuring system-wide compliance with evolving regulatory standards. You will be instrumental in fostering a culture of continuous learning and precision, directly...

Revenue Cycle Coder III-Inpatient CodingInspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 158 hospital-based locations, in addition to its home-based services and virtual care offerings.As our Advanced Coding & CDI Educator, you will leverage your expert knowledge in ICD-10-CM, ICD-10-PCS, and CPT-4 coding to drive excellence in our health information management (HIM) department. This critical role focuses on elevating coding accuracy, enhancing Clinical Documentation Improvement (CDI) practices, and ensuring system-wide compliance with evolving regulatory standards. You will be instrumental in fostering a culture of continuous learning and precision, directly...

Job Summary and Responsibilities As our Revenue Cycle Coder III-Inpatient Coding, you will leverage your expert knowledge in ICD-10-CM, ICD-10-PCS, and CPT-4 coding to drive excellence in our health information management (HIM) department. This critical role focuses on elevating coding accuracy, enhancing Clinical Documentation Improvement (CDI) practices, and ensuring system-wide compliance with evolving regulatory standards. You will be instrumental in fostering a culture of continuous learning and precision, directly impacting our revenue cycle integrity and healthcare data quality. Every day you will serve as a primary resource for complex coding and billing inquiries, providing authoritative guidance and problem-solving expertise. You will design, develop, and deliver comprehensive coding and CDI education programs, onboarding new staff, and conducting targeted training sessions across the health system. A key part of your role involves performing rigorous coding and DRG...

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process. CERTIFIED MEDICAL CODER 3 days ago Requisition ID: 1023 Bone & Joint Specialist is looking for a Certified Medical Coder. In position you will be responsible for accurately translating medical diagnoses, procedures and services from physician notes into standardized codes (like ICD-10, CPT) for billing insurance, ensuring compliance, resolving claim denials, communicating with providers for clarification and facilitating timely reimbursement for healthcare services. DUTIES AND RESPONSIBILITIES: Review and analyze medical records and patient information to ensure accurate billing. Verify patient insurance coverage and process claims for reimbursement. Communicate with healthcare providers to resolve any billing discrepancies or issues. Maintain up-to-date knowledge of coding guidelines and regulations. Collaborate with other...

Overview Responsible for ensuring accuracy and quality coding assignments for all records requiring DRG and/or APC coding; ensures optimal and timely reimbursement. Responsibilities Principal Duties and Responsibilities (*Essential Functions) Performs comprehensive pre-billing coding audits, through the use of eValuator , to ensure claims are accurately coded and charged in compliance with coding and regulatory standards. Performs comprehensive pre-billing coding data quality reviews on inpatient and/or outpatient records to ensure proper coding guidelines have been followed and appropriate DRG (MS/APR) or APC assignments have been made for appropriate reimbursement. Responsible for completion of reviews within 72 hrs of import date to include new reviews of up to or exceeding 12 to 15 per day for inpatients and/or completion of reviews within 48 hrs of import date including up to or exceeding 50 per day for outpatient accounts. Maintains an audit response...

Jamison Professional Services, Inc. (“Jamison”) is currently seeking a qualified and motivated candidate for the position of Certified Inpatient/Outpatient Medical Coder (Medical Records Technician). Certified Inpatient/Outpatient Medical Coder. Candidates must hold at least one current certification from AHIMA or AAPC, including: Registered Health Information Technician - RHIT Certified Coding Specialist - CCS Certified Coding Specialist–Physician Based - CCS-P Registered Health Information Administrator - RHIA Certified Professional Coder - CPC Candidates must provide documentation verifying their current certification. DESCRIPTION OF SERVICES: The Medical Records Technicians - Inpatient/Outpatient Coders will provide remote medical coding services in support of a federal healthcare client. The selected candidates will perform inpatient and outpatient medical records coding, coding validation, documentation review, provider queries, and related health information...

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## Associate Director, Global Medical ReviewApplylocations: Princeton, NJtime type: Full timeposted on: Posted Todayjob requisition id: R12728The Associate Director, Global Medical Review provides input into the medical review of safety data for investigational and marketed products. The role is responsible for ensuring high-quality medical review activities, consistency across internal and external reviewers, and compliance with global pharmacovigilance regulations and company procedures.The Associate Director serves as an expert contributor and subject matter expert resource within Global Pharmacovigilance, partnering with Medical Safety Product Leaders, PV Operations, Regulatory Affairs, Clinical Development, Quality, affiliates, and vendors to support patient safety.Demonstrate flexibility and responsiveness by being available on-site, when required, to support critical business activities, cross-functional engagements, audits, inspections, and regulatory...

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best.Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale.Join us to start Caring. Connecting. Growing together. You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Review provider documentation and medical records to assign appropriate diagnosis and procedure codes Abstract and code professional fee services for non-invasive cardiology procedures, including but not limited to: Stress testing (exercise and pharmacologic)...

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best.Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale.Join us to start Caring. Connecting. Growing together. You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Review provider documentation and medical records to assign appropriate diagnosis and procedure codes Abstract and code professional fee services for non-invasive cardiology procedures, including but not limited to: Stress testing (exercise and pharmacologic)...