Diagnosis Related Group (DRG) Readmission Auditor

This is a fully remote position, open to applicants in United States.

📋 Description

• Perform thorough reviews of MS-DRG and APR-DRG readmissions to ensure precise DRG assignment and reimbursement accuracy.

• Leverage expert knowledge of coding standards and employ leading industry tools to optimize overpayment identification.

• Develop clear, concise, and well-substantiated audit findings.

• Utilize advanced DRG encoding tools (such as 3M, Webstrat) to enhance efficiency and accuracy during audits.

• Achieve or surpass EXL’s quality and productivity benchmarks.

• Remain informed about industry trends, coding updates, and compliance regulations.

⛳️ Requirements

• At least a High School Diploma (higher education is preferred).

• CCS, RHIA, or RHIT certification (multiple credentials are preferred).

• Over 4 years of experience in MS-DRG/APR-DRG coding.

• Previous experience in auditing for DRG readmission retrospective overpayment identification is highly valued.

• Strong expertise in using DRG encoder tools (3M, Webstrat).

• In-depth knowledge of inpatient coding with a thorough understanding of ICD-10-CM/PCS coding guidelines.

• Outstanding time management, problem-solving, and analytical abilities.

• Excellent written and verbal communication skills with a keen attention to detail.

• Proficient in Excel, Word, and OneNote, demonstrating strong overall computer literacy.

• A passion for DRG readmission auditing, along with a dedication to teamwork, collaboration, and continuous learning.

🏝️ Benefits

• A dynamic, innovative environment alongside a team of industry-leading professionals.

• Practical experience with top-tier clients in the healthcare sector.

• Access to mentorship and career development initiatives.

• A robust culture emphasizing collaboration, support, and inclusivity.

• A competitive benefits package, including healthcare, vision, dental, and 401(k) options.