DRG Auditor I

Job Summary

As a fully remote opportunity for new graduates, the DRG Auditor I will conduct audits of outpatient medical records to ensure compliance with regulatory requirements and payer guidelines while developing skills in auditing and compliance.

Key responsibilities:

• Conduct comprehensive MS-DRG and APR-DRG coding reviews to ensure accuracy in DRG assignment and reimbursement
• Apply knowledge of coding guidelines and utilize industry-leading tools to maximize overpayment identifications
• Craft clear and concise audit findings, supported by AHA Coding Clinic Guidelines and ICD-10-CM/PCS regulations

Required qualifications:

• One or more of the following credentials: CCS, RHIA, RHIT, CPC
• Associates degree or 1 year of experience
• Knowledge of coding guidelines
• Experience with encoder tools (3M, Webstrat, Optum Encoder)
• Ability to work independently in a remote environment during core business hours