DRG Auditor I

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

📋 Description

• Execute thorough reviews of MS-DRG and APR-DRG coding to ensure precise DRG assignment and reimbursement.

• Utilize coding standards and top-tier tools to detect overpayments.

• Compile clear, succinct, and well-supported audit findings in accordance with AHA Coding Clinic Guidelines and ICD-10-CM/PCS regulations.

• Leverage DRG encoder tools such as 3M and Webstrat to enhance audit efficiency and precision.

• Achieve or surpass quality and productivity benchmarks, including maintaining high appeal uphold rates.

• Stay updated on industry trends, coding modifications, and compliance regulations.

⛳️ Requirements

• One or more of the following credentials are mandatory: CCS, RHIA, RHIT, CPC.

• An associate degree or a minimum of 1 year of relevant experience.

• Familiarity with coding guidelines.

• Understanding of Official Guidelines for Coding and Reporting and Coding Clinic Guidance.

• Experience with encoder tools such as 3M, Webstrat, or Optum Encoder.

• Capability to operate independently in a remote setting during EXL core business hours.

• Strong time management and task prioritization abilities.

• Excellent written and verbal communication skills, along with analytical capabilities and meticulous attention to detail.

• Proficiency in Excel, Word, and OneNote.

• General computer literacy.

• A genuine passion for DRG auditing.

• A brief coding/auditing assessment may be included as part of the interview process.

🏝️ Benefits

• Options for healthcare, vision, dental, and 401k plans.

• A mentoring program that pairs junior employees with experienced professional advisors.

• Access to guidance and coaching.

• Opportunities to collaborate with seasoned healthcare consultants.

• Professional growth and development opportunities.

• Development of teamwork and time-management skills.