455 drg coding auditor jobs found

Job Description The Patient Safety 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. The role generates highly complex audit findings recoverable claims for the benefit of the Company across all lines of business. The position focuses on very complex coding cases paid through various DRG methodologies such as APS-DRG, APR-DRG, AP-DRG, MS-DRG, or TRICARE, with findings that may be reviewed only by other DRG Coding Audit Principals or Executives. Responsibilities Analyzes and audits claims by integrating advanced medical chart coding principles found in Official Coding Guidelines, Coding Clinics, and the ICD-10 Alphabetic and Tabular Indices, as well as complex clinical guidelines, maintaining objectivity in audit activities. Draws on extremely advanced ICD-10 coding expertise, clinical guidelines, and industry knowledge to substantiate sophisticated...

The Elevance Health Companies, Inc. is seeking a Patient Safety DRG Coding Auditor Principal responsible for auditing inpatient medical records based on DRG methodology. This role is critical for generating complex audit findings and supporting claims recovery for various business lines. Candidates must have extensive experience in claims auditing and relevant certifications. The position is primarily independent, with responsibilities that include analyzing claims and suggesting process improvements. The company offers a competitive salary range of $116,128 to $210,864 and a robust benefits program. #J-18808-Ljbffr

Anticipated End Date: 2026-07-24 Position Title: Patient Safety DRG Coding Auditor Principal Job Description: Location: This role enables associates to work virtually full-time, except for 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 accommodation is granted as required by law. The Patient Safety 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...

Inpatient Drg Coding Auditor 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! Job 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...

Location: This role enables associates to work virtually full-time, except for 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 accommodation is granted as required by law. The Patient Safety 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...

Patient Safety DRG Coding Auditor Principal Location: This role enables associates to work virtually full-time, except for 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. The Patient Safety 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 physician's statement provided by acute care hospitals on paid DRG, especially on very complex coding cases that are paid using APS-DRG,...

Location: This role enables associates to work virtually full-time, except for 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 accommodation is granted as required by law. The Patient Safety 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...

Inpatient Drg Coding Auditor 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! Job 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...

Emory Healthcare is seeking an experienced Inpatient DRG Coding Auditor in Atlanta, Georgia. The role involves reviewing inpatient medical records for coding accuracy and completeness, conducting audits, and coordinating with clinical staff to improve documentation. Candidates should have a Certified Coding Specialist (CCS) certification and a minimum of five years of experience in ICD-10 coding within an acute care setting. The position offers comprehensive health benefits and additional support programs to ensure your professional growth. #J-18808-Ljbffr

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,...

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. Responsibilities Essential Functions Reviews inpatient medical records post-discharge and pre-bill, audits the accuracy and completeness of diagnoses, procedure coding, abstracted data and DRG assignment. Reviews non-CC/MCC records to determine if the record was coded correctly or if additional codes may be reported by obtaining documentation supported by clinical indicators and treatment. Develops and coordinates coding education and formal training programs. Improves documentation by participating in the CDI query audit process. Works effectively with the Coding Manager to improve...

Job Title University of Utah Health Coding Specialist Job Description 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. 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...

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 our...

Huron Consulting Group Inc. in Chicago is seeking an Inpatient Coding Auditor to review inpatient coders and offshore auditors, ensuring DRG accuracy of at least 95% and coding quality. You will communicate findings via phone, email, and instant messaging with client teams and payers, and report to the Huron Managed Services Domestic Coding team. Responsibilities include audits, quality checks, calibration sessions, and preparing reports with clear, actionable feedback. #J-18808-Ljbffr

A leading health services company is seeking an Inpatient Medical Coding Auditor to review hospital claims. This remote position requires expertise in medical coding, specifically MS-DRG. The ideal candidate will hold a relevant certification with at least four years of experience. Responsibilities include ensuring accurate claims payment and handling provider disputes. Additional requirements include strong communication skills and ability to manage multiple priorities. The role offers a competitive salary, flexible work hours, and comprehensive benefits. #J-18808-Ljbffr

Thank you for considering a career at Ensemble! Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country. Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference! O.N.E Purpose: Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations. Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation. Striving for...

A leading health services company is seeking an experienced Inpatient Medical Coding Auditor to perform coding audits and ensure accurate provider reimbursements. This remote position requires certifications such as RHIA, RHIT, or CCS, and proficiency in MS-DRG coding, claims interpretation, and Microsoft Office. Strong communication and detail orientation are essential for success in our supportive, flexible work environment, where candidates will also enjoy competitive benefits and potential bonuses. #J-18808-Ljbffr

A healthcare technology firm is seeking a Nurse Coder DRG Auditor to validate coding accuracy and medical necessity of inpatient claims. The role involves applying industry standards and guidelines to perform DRG validations while collaborating within a team. Successful candidates will have an active RN license, relevant coding certifications, and experience in clinical practice. A competitive salary of $85,000 to $90,000 is offered, along with a comprehensive benefits package. #J-18808-Ljbffr

A leading healthcare organization seeks an Inpatient Medical Coding Auditor to work remotely. The role involves reviewing inpatient hospital claims for correct reimbursement and managing provider disputes. Candidates should have RHIA, RHIT or CCS Certification and MS-DRG coding experience. The position offers bonuses and competitive benefits including medical and retirement plans. Exceptional communication skills and attention to detail are essential. You will contribute to cost reduction by ensuring accurate payments in the healthcare system. #J-18808-Ljbffr

A leading healthcare organization is seeking an Inpatient Medical Coding Auditor to work primarily from home. In this role, you'll be responsible for reviewing and coding inpatient hospital claims, ensuring accuracy for reimbursement. The ideal candidate will have a strong background in medical coding with a focus on MS-DRG, certifications like RHIA or CCS, and the ability to work independently. The position offers a competitive salary, a bonus incentive plan, and comprehensive benefits, fostering a supportive work environment. #J-18808-Ljbffr

A leading health insurance company is seeking an experienced Inpatient Medical Coding Auditor to work remotely. Responsibilities include reviewing inpatient hospital claims for reimbursement, extracting clinical information, and assigning medical codes. A minimum of 4 years of RHIA, RHIT, or CCS certification is required, along with MS-DRG coding experience. The position offers a competitive salary and benefits to support overall well-being, with a focus on work-life balance. #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 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

Thank you for considering a career at Ensemble! Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country. Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference! O.N.E Purpose: Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations. Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and...