Senior DRG Coding Auditor - Remote & Complex Claims
Elevance Health
- Remote job
Elevance Health is seeking a DRG Coding Auditor Principal to audit inpatient medical records using DRG methodologies across multiple lines of business. The role emphasizes highly complex coding cases and independent work with minimal oversight. Responsibilities include applying ICD-10 coding guidelines, validating documentation quality, and generating detailed audit findings letters for recovery opportunities. A strong track record in DRG audits and certifications is required. #J-18808-Ljbffr Elevance Health
$30.46 - $45.69 per hour
Billing Compliance, Senior Auditor Hourly Pay Range:... ...(Evanston, IL and remote) Hours: Monday‑... ...retrospective and prospective coding, billing, and... ...Manuals, and DRG/APC/RBRVS/other relevant... ...interviews, claim reviews, control assessments... ...ability to convey complex coding and...Remote workSeniorClaimsHourly payFor contractorsMonday to Friday$70k - $80k
...of healthcare’s most complex challenges. Join us and... ...individual for an Inpatient Coding Auditor, Senior Associate who is... ..., specifically the MS-DRG, AP-DRG, APR-DRG, ASC,... ...perform reviews of multiple claim types to provide a... ...in this role ~ Remote within the U.S. ~ Benefits...Remote workSeniorClaimsFull timeContract workFlexible hours$90k - $105k
...of healthcare’s most complex challenges. Join us and... ...individual for a Clinical DRG Auditor who is responsible for... ...validation (clinical/coding) reviews of medical... ...codes for inpatient claims. Consistently achieves... ...in this role Remote within the U.S. May...Remote workClaimsFull timeContract workFlexible hours- ...DRG Auditor The DRG Auditor is responsible for reviewing... ...post-billed inpatient claims to identify and... ...diagnosis and procedure coding. Working within a specialized... ...office-based or remote, depending on company... ...employer of choice in the complex claims industry,...Remote jobClaimsFlexible hours
- ...Elevance HealthPosted: 2026-08-19Elevance Health is seeking a DRG Coding Auditor to ensure accuracy in MS-DRG and APR-DRG classifications... ...coding expertise to audit and generate high-quality recoverable claims for the company and its clients.The position offers hybrid/virtual...Remote workClaims
- ...2026-08-20Elevance Health is seeking a DRG Coding Auditor to review inpatient records and ensure... ...expertise, and document audit findings. Hybrid/remote work with occasional in-person training... ...emphasizes high-quality recoverable claims across lines of business, using audit...Remote workClaims
- ...seeking an experienced Inpatient Medical Coding Auditor to perform coding audits and ensure accurate provider reimbursements. This remote position requires certifications such... ..., RHIT, or CCS, and proficiency in MS-DRG coding, claims interpretation, and Microsoft Office....Remote workClaimsWork at officeFlexible hours
- ...detailed-oriented professional to conduct inpatient DRG reviews. The role requires an RN or LVN and an inpatient coding certification within 4-6 months of hire.... ...reviews while documenting findings and managing claims. An excellent compensation package and benefits...Remote workClaims
$28k
...Senior Premium Auditor (Workers' Compensation) | 100% Remote Opportunity General Summary... ...Typically conducts the most complex physical premium audits... ...Analyze and review claims to verify employment, proper classification coding and proper allocation of...Remote workSeniorClaimsWork from home- ...Olympia, WA, is seeking an Inpatient Medical Coding Auditor. The role involves reviewing inpatient hospital claims for proper reimbursement and requires... ...including RHIA, RHIT, or CCS certification with MS-DRG experience. This remote position allows for flexible work hours and...Remote workClaimsFlexible hours
$85k - $95k
RCM Healthcare Services is seeking a DRG Coding Reviewer to support inpatient coding validation... ...and payment integrity initiatives. This remote, full-time role offers a salary of $85,0... ..., and PTO. You will review inpatient claims to validate ICD-10 coding and DRG...Remote jobClaimsFull time- ...DRG Validation Auditor Insight Global is seeking a DRG Validation Auditor for... ...of our clients to sit 100% remote. This person should have an... ...documentation, and/or inpatient coding and has a high level of... ...generating high-quality recoverable claims for the benefit of our...Remote workClaims
- The Elevance Health Company seeks a DRG Coding Auditor to audit inpatient medical records and generate high-quality recoverable claims for all lines of business. You will apply advanced ICD-10 coding principles and DRG logic to substantiate conclusions and ensure accurate...Remote jobClaims
- ...Diagnosis Related Group Clinical Validation Auditor-RN to audit inpatient medical records,... .... The role emphasizes ICD-10 coding expertise and DRG validation across multiple DRG types.... ...included. Requires extensive experience in claims auditing and clinical documentation...Remote jobClaims
- Elevance Health is seeking a DRG Coding Auditor to audit inpatient medical records and generate recoverable claims across lines of business, ensuring accurate DRG assignment... ...and internal teams. The role offers hybrid/remote work with required in-person training. #J-1...Remote jobClaims
- ...UnitedHealth Group, seeks a Senior Inpatient Medical Coder/Acute Edits and Denials Claims Analyst to work remotely from anywhere in the U.S. You... ...applying ICD-10-PCS and DRG rules to inpatient records.... ...with a focus on high-quality coding and compliant billing practices...Remote jobSeniorClaims
- ...financial experience. The Senior Content Ideation Specialist... ...Itemized Bill Review and DRG Validation within the Expert Claim Review suite, sourcing from... ...content and supports DRG Coding and Clinical Validation (MS... ...; in-office and hybrid/remote options #J-18808-Ljbffr 3...Remote jobSeniorClaimsWork at office
- ...healthcare services provider is seeking an Inpatient Medical Coding Auditor to work remotely. This role involves extracting clinical information from... ...and ensuring proper reimbursement for inpatient hospital claims. Ideal candidates will have at least four years of...Remote workClaimsContract work
$35 - $62.5 per hour
...this position as a Clinical DRG RN auditor , you will apply your expert... ...knowledge of the MS-DRG and APR-DRG coding/reimbursement methodology... ...in the auditing of inpatient claims. Employing both industry and... ...Ability to work independently in a remote environment and deliver...Remote workClaimsHourly payDaily paidMinimum wageFull timeTemporary workPart timeWork experience placementWork at officeLocal areaRelocation package$122.24k - $183.36k
...accommodation is granted as required by law.The DRG Coding Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (... ...case rate and per diem, generating highly complex audit findings recoverable claims for the...ClaimsDaily paidFull timeTemporary workWork experience placementWork at officeLocal area1 day per week- ...Job Title Healthcare Compliance Auditor Job Description This position reports to... ...Responsibilities include conducting billing and coding audits, and communicating results and... ...used for coding and billing for medical claims. Knowledge of medical terminology,...Remote jobSeniorClaimsWork experience placementWork at office
$71.1k - $97.8k
...Join Our Caring Community The Senior Medical Coding Outpatient Auditor is responsible for coding-focused audit... ...Key Responsibilities Research claims anomalies to identify outpatient audit... .... Travel: While this is a remote position, occasional travel to Humana...Remote workSeniorClaimsTemporary workApprenticeshipWork at officeWork from homeHome office- ...TEEMA Solutions Group is seeking a Senior Clinical Coder for a fully remote opportunity focused on inpatient facility coding and DRG validation. You will support clinical operations teams in complex medical claims reviews and ensure coding accuracy. The ideal candidate...Remote workSeniorClaimsPermanent employment
$71.1k - $97.8k
...Senior Medical Coding Outpatient Auditor Become a part of our caring community The Senior Medical Coding... ...Key Responsibilities Research claims anomalies to identify outpatient audit... ...information. Travel: While this is a remote position, occasional travel to...Remote workSeniorClaimsTemporary workApprenticeshipWork at officeWork from homeHome office- ...Coding Auditor Department: SIU Employment Type: Full Time Location... ...detail, eager to learn complex audit frameworks,... ...and codes billed on a claim to a medical record. Compare... ...HCPCS, Revenue Codes, DRG codes, and ICD-10 from... ...initiatives Remote work eligible REMOTE WORK...Remote workClaimsHourly payFull timeFlexible hours
- A leading healthcare company is seeking an Inpatient Medical Coding Auditor to join their team remotely. The role involves reviewing inpatient hospital claims for proper reimbursement, analyzing medical data, and ensuring accuracy in coding. Candidates should have relevant...Remote jobClaims
$71.1k - $97.8k
...The Inpatient Medical Coding Auditor extracts clinical information... ...involve moderately complex to complex issues... ...review inpatient hospital claims for proper... ...diagnosis related group (DRG) assignments. Analyzes... ...impact WORK STYLE: Remote/work at home. While this...Remote workClaimsBi-weekly payFull timeContract workTemporary workApprenticeshipWork at officeWork from homeHome officeMonday to Friday$52.69 - $69.82 per hour
...Day - 08 Hour R2658919 Remote USA 108610021 Admin... ...Overview Billing and Coding Compliance Auditors conduct audits and monitoring... ...Management criteria, DRG and APC assignments,... ...nature, scope, and complexity of assigned duties,... ...errors before claims submission, ensuring...Remote workClaimsHourly payFull timeWork experience placementWork at office$70k - $83k
...year Department: Ops - Claims Ops About the Role: We... ...a highly motivated Senior Claims Auditor. This role will report... ...and workflows Handle complex and urgent audit projects... ...-Cal fee schedule, AP-DRG, APC) Detail knowledge... ...DRG payment systems, coding edits, Medicare guidelines...SeniorClaimsWork at office$71.1k - $97.8k
...Certified Inpatient Medical Coding Auditor to review inpatient hospital claims for proper reimbursement... ...-10-CM, ICD-10-PCS, and DRG codes Audit coding... ...fact-based approach Analyze complex clinical documentation and... ...Travel: While this is a remote position, occasional travel...Remote workClaimsFull timeContract workTemporary workApprenticeshipWork at officeWork from homeHome officeMonday to FridayShift work
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