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DRG Validation Auditor -Contractor

Remote, USA Full-time Posted 2025-07-27
    DRG Validation Auditor -Contractor is a remote role that involves validating the accuracy of ICD-10-CM, ICD-10-PCS, and DRG and APR group appropriateness, CPT and HCPCS inpatient patient and outpatient facility claims. The ideal candidate needs to have both inpatient and outpatient coding / auditing background focused on pediatric healthcare services and coding accuracy and payer claim processing.Requirements
  • Extensive knowledge of healthcare industry and experience in and around coding, billing, auditing, compliance and reimbursement for Inpatient and Outpatient facility
  • 5 years of auditing facility inpatient and outpatient services with DRG and APR-DRG as well as familiarity with clinical documentation improvement practices
  • Proficiency in coding software, electronic health record systems and familiar with how AI tools can assist in identifying over/under-assigned DRGs
  • Benefits
  • Competitive salary
  • Opportunity to work in a dynamic environment with a high-performing team
  • Chance to inform the next generation in auditing software

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