Diagnosis-Related Group Manager

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

📋 Description

• Direct the planning, coordination, and implementation of DRG audit initiatives

• Supervise a team of auditors focused on MS-DRG and APR-DRG evaluations

• Manage inventory, aging, risks, and daily performance metrics

• Collaborate across various departments to enhance program effectiveness

• Guarantee precise coding and reimbursement results

• Stay updated on regulatory and payer guideline changes, ensuring audit compliance

⛳️ Requirements

• CCS, RHIT, or RHIA certification is preferred

• 5–8 years of experience with MS-DRG and APR-DRG, with a robust understanding of ICD-10-CM/PCS and Official Coding Guidelines

• Previous experience in leadership roles or supervisory positions

• Comprehensive knowledge of DRG reimbursement processes

• Familiarity with Medicare, Medicaid, and commercial payer regulations

• Experience in audit or payment integrity operations

• Strong analytical abilities to identify trends and facilitate decision-making

• Excellent communication and interpersonal skills

• Proficient in Microsoft Office and audit/reporting software

🏝️ Benefits

• Up to 10% annual travel

• Competitive benefits package, including healthcare, vision, dental, and 401(k) options