DRG Auditor - Remote

Job Summary

Working remotely in a full-time capacity, the DRG Auditor will review and validate medical records, ensuring compliance with coding standards and regulations while managing denials and underpayment audits.

Key responsibilities

• Review medical records for accuracy and compliance with coding guidelines
• Validate DRG assignments and manage denial resolutions
• Conduct audits to identify underpayments and recommend corrective actions

Required qualifications

• Certified Coding Specialist (CCS) or equivalent certification
• Experience in DRG auditing and healthcare reimbursement processes
• Strong knowledge of ICD-10-CM and CPT coding systems
• Proficiency in medical record documentation and compliance standards
• Ability to work independently in a remote environment