DRG Revenue Integrity Auditor
Internationalinsuranceprofessionals
Join a Team of Industry-Leading Experts and Help Shape the Future of Revenue Integrity Are you a passionate coding and revenue integrity professional who thrives on clinical accuracy, continuous learning, and making a meaningful impact? At CorroHealth, you'll work alongside some of the nation's most respected physicians, clinical leaders, coding experts, and healthcare innovators to ensure the highest standards of coding accuracy and revenue integrity for leading healthcare organizations. As a global healthcare solutions company, we invest in our people through continued education, career advancement opportunities, mentorship from industry experts, and a flexible work environment that supports work-life balance. If you're looking for an opportunity to elevate your expertise while partnering with exceptional clients and colleagues, we'd love to hear from you. **Sign on bonus available** What You'll Do The DRG Revenue Integrity Auditor (DRG-A) performs comprehensive Diagnostic Related Group (DRG) validation and quality audits on inpatient medical records to ensure accurate representation of each patient's clinical story. In this role, you will: Perform detailed DRG validation reviews of inpatient charts. Ensure assigned
ICD-10-CM/PCS
codes accurately reflect the patient's clinical condition and treatment. Validate proper sequencing and accuracy of diagnoses and procedures. Review and assess: Present on Admission (POA) indicators Severity of Illness (SOI) Risk of Mortality (ROM) Case Mix Index (CMI) Hierarchical Condition Category (HCC) capture Other coding and reimbursement factors Utilize current coding references and clinical criteria including: ICD-10-CM/PCS CMS Guidelines MCG InterQual National Coverage Determinations (NCDs) Local Coverage Determinations (LCDs) Payer clinical policy guidelines Adhere to coding guidelines and CDI best practices endorsed by AHIMA and ACDIS. Identify documentation gaps and formulate compliant physician queries when appropriate. Analyze records for coding opportunities, sequencing accuracy, and clinical support. Maintain high-quality review standards while meeting productivity and quality expectations. Stay current with regulatory, coding, reimbursement, and clinical documentation updates. Support development of training content and educational resources. Mentor and provide shadowing opportunities for new team members. Assist with project analysis, reporting, and client-facing feedback initiatives. Participate in internal and external audits of Clinical Documentation Integrity (CDI) programs. Protect patient privacy and ensure proper handling of all PHI in accordance with company policies and regulatory requirements. Attend required meetings, training sessions, and educational programs. Perform other duties as assigned. Why CorroHealth? At CorroHealth, our people are our greatest asset. We foster a culture where healthcare professionals can grow, collaborate, and make a real impact. Work Experience: Five or more years working in an acute care setting or a third-party vendor as a DRG Auditor or Clinical Documentation Specialist (CDS). CCS required, CCDS or CDIP a plus Knowledge, Skills & Abilities: Experience with telecommuting and electronic medical record systems required Good computer skills and familiarity with commonly used work apps, such as MS Word, MS Excel, MS Outlook, Teams, etc. Strong analytical skills Works well with numbers, using basic math skills Strong team player Ability to work with multiple and diverse clients and projects Ability to switch between multiple clients throughout the day and week Ability to work with minimal supervision Ability to maintain and access multiple files #J-18808-Ljbffr Internationalinsuranceprofessionals- ...charges are ordered, documented, and supported. The role blends acute care nursing judgment with chart auditing, coding, and revenue integrity in a fully remote, direct-hire setting. The ideal candidate is an active RN with 5+ years in ICU/ER/OR, 1+ year in chart auditing...SuggestedRemote job
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...organizations. Ovation Healthcare’s vision is to be a dynamic, integrated professional services company delivering innovative and... ..., TN. For more information, visit Summary: The Revenue Cycle QA Auditor, reflects the mission, vision, and values of Resolution RCM...SuggestedHourly payFull timeTemporary workWork at officeLocal areaFlexible hours- Partner Company in the United States is seeking an Underpayment Analyst to join a healthcare revenue integrity team. You will focus on analyzing hospital claims and identifying reimbursement discrepancies, with a strong emphasis on accuracy and compliance. This remote role...SuggestedRemote job
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...Conducts root-cause analysis and escalates systemic issues to Revenue Integrity. Evaluates upstream workflow breakdowns (registration errors,... ...facility billing, payer remits, CARC/RARC codes, and OPPS/APC/DRG methodologies strongly preferred. Skills & Knowledge: Strong analytical...Shift workDay shift$60k - $75k
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A healthcare technology firm is seeking a Nurse Coder DRG Auditor to validate coding accuracy and medical necessity of inpatient claims. The role involves applying industry standards and guidelines to perform DRG validations while collaborating within a team. Successful...$52.1k - $78.15k
...Ensemble!Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals... ...with denial prevention, audit & appeals, and revenue integrity teams Proactively elevate emerging risks with recommended corrective...Temporary workWork at officeLocal areaRemote work- ...The Integration Analyst executes the end-to-end finance integration of acquired companies, from Day 1 readiness through system conversion... ...billing, cash receipts, and cash application, and align revenue recognition, deferred and unbilled revenue, and allowance methodology...Interim roleWork at officeRemote work
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...operating principles that guide every decision we make. The Premium Auditor I is responsible for conducting standard premium audits for... ...to building positive relationships while maintaining audit integrity. Adaptability: Flexibility to work with evolving technologies and...For contractorsWork experience placementWork at officeRemote work- Campaign Finance Board in New York City seeks Auditors to join the Auditing & Accounting Unit. You will analyze financial records, conduct desk and field audits, and ensure compliance with the Campaign Finance Act and Board Rules. The role involves planning, reporting,...
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