Remote DRG Revenue Integrity Auditor
Internationalinsuranceprofessionals
- Remote job
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- ...Intermountain Health is seeking a Revenue Integrity RN Charge/Coding Auditor to consult on clinical charge audits for Intermountain Health facilities. The role audits medical records for denials, defense reviews, and retrospective analyses while ensuring compliance with...Remote work
$85.7k - $129.31k
...Job Description: The Revenue Integrity RN Charge/Coding Auditor is responsible for consulting on clinical charge Audits for Intermountain Health. The RN... ...through Microsoft Teams will be required as well for fully remote position. Essential Functions · Use nationally...Remote workHourly payFull timeWork at officeFlexible hours- Intermountain Health is seeking a Revenue Integrity RN Charge/Coding Auditor to conduct clinical charge audits for denials review and retrospective reviews... ...resource across Revenue Cycle departments. This remote role requires knowledge of charging, coding, and healthcare...Remote job
- ...Day Shift Description Purpose: Work Remote Position (Pay Range: $21.5178-$32.2766)... ...laws / regulations, Trinity Health Integrity & Compliance Program & Code of Conduct,... ...Provides feedback to intra-departmental Revenue Integrity colleagues including areas of...Remote jobFull timeWork experience placementLocal areaShift workDay shift
- Intermountain Health seeks an RN Charge Auditor specializing in revenue integrity to consult on clinical charge audits, review denials, and support hospital charging and coding accuracy. This remote, full-time role partners with stakeholders across revenue cycle, ensuring...Remote jobFull time
- ...time Shift: Day Shift Purpose: Work Remote Position The Nursing Support (NS)... ...local laws/regulations, Trinity Health Integrity & Compliance Program & Code of Conduct,... ...Must possess a demonstrated knowledge of revenue cycle & denial management functions....Remote jobFull timeLocal areaShift workDay shift
- ...EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations... ...claims, and expert human-in-the-loop integration, EnableComp provides solutions across the... ...umbrella, including Diagnosis-Related Group (DRG & DRGV), and Medical Necessity Denials...Remote workFull timeWork at officeFlexible hours
- ...is seeking a Compliance Auditor (RN) to support compliance, clinical, and revenue-focused auditing... ...healthcare auditing, revenue integrity, compliance, or coding.... ...Audit facility coding and DRG assignments to identify... .... Primary Location: Remote - Florida123 Remote...Remote work
$73k - $98.7k
...Are you a passionate and experienced DRG Auditor looking for an opportunity to thrive in a... ...join our team! This role offers a fully remote work experience with possible 10% travel... ...innovation, collaboration, excellence, integrity and respect. We are headquartered in New...Remote workFull timeWork experience placementWork from homeHome office$95k
...Overview This DRG Validation Auditor role is focused on our Cross Claim Clinical Reviews (CCCR).... ...Responsibilities Analyzes and Audits Claims. Integrates medical chart coding principles,... ...if a qualified candidate is selected. #LI-Remote #LI-JB1 #senior...Remote workHourly payFull timeReliefWork at officeImmediate startShift workNight shiftWeekend workAfternoon shift$76k - $99k
...The Payment Integrity team is a group of innovative thinkers sitting at the intersection... ...inappropriate medical spend. As an DRG Validation Auditor at Clover Health, you will play a key... ...off policy. Additionally, we embrace a remote-first culture that supports collaboration...Remote workFull timeWork experience placementWork at officeFlexible hours- ...clinical outcomes and data integrity. Key responsibilities... ...lines.This is a remote position that may require... ...Director of the Pre-bill DRG Validation Program. This... ...validation reviewers, coding auditors, and CDI specialists;... ...prevention, and net revenue impact. This role is...Remote workWork at officeImmediate startShift work
- ...include audit recommendations. Conducts revenue cycle investigations to determine and mitigate... ...RequiredCertified Professional Medical Auditor (CPMA) or Certified E&M Auditor (CEMA)... ...Health is a faith-based, nonprofit, integrated health system serving more than 100 communities...Remote workWork experience placement
$31.06 - $46.59 per hour
...Billing Compliance, Senior Auditor Reporting to the... ...Hybrid (Evanston, IL and remote) Full Time/Part Time:... ...Medicare Manuals, and DRG/APC/RBRVS/other... ...facility/professional revenue cycle experience. Extensive... ...Endeavor Health is a fully integrated healthcare delivery...Remote workHourly payFull timeContract workPart timeFor contractorsMonday to Friday- Acclivity Healthcare seeks a System Supervisor - Charge Audit/Claim Edit to lead charge audit operations and revenue integrity initiatives. This full-time, work-from-home role focuses on accurate charge capture, denials reduction, and improved claims quality through auditing...Remote jobFull timeWork from home
- Trinity Health in Livonia, Michigan is seeking a Nursing Support (NS) colleague to provide safe, quality care under the supervision of a registered nurse. The role includes direct and indirect nursing interventions within the scope of practice and compliant with hospital...Remote job
- ...Revenue Integrity Specialist The Revenue Integrity Specialist supports accurate, complete, and timely professional billing for anesthesia services across the Hospital Based Provider Group in Palm Beach County. The specialist identifies missed charges, documentation...Full timeShift work
- Elevance Health is seeking a DRG Coding Auditor to ensure accurate, compliant inpatient reimbursement and support whole-health care for our members. In this remote role, you will perform detailed retrospective and prospective DRG audits, reviewing medical records and ICD...Remote work
- ...educate staff on coding changes. This role supports DRG assignments and reimbursement integrity across the revenue cycle. Applicants should have 5+ years of... ...and the ability to work independently, including remote collaboration with clinicians and coders. #J-188...Remote work
$52.79k - $76.46k
...over $8 billion in annual revenue. With nearly five... ...Medicare Advantage, fully integrated care models, primary care... ...Job The Claims Auditor will perform various... ...as CPT4, ICD9, ICD10, DRG and HCPCS.Completion of... ...76 per hour Work Mode: Remote Annual bonus program Robust...Remote workHourly payFull timeFor contractors- ResponsibilitiesCompile, gather, and review medical record data as needed for Revenue Integrity audits and third party payor audits. Maintain records of audit projects and internal reviews. Coordinate with HIM as needed to respond to documentation requests. Review records...Remote workWork from home
- CorroHealth Inc is seeking a Director of the Pre-bill DRG Validation Program to own strategy, operations, quality, and financial performance... ...outcomes like accuracy, turnaround, and denial prevention. Remote role with 15-25% travel. Requires RN/MD/NP/PA with CDS coding...Remote job
- Anthem Insurance Companies Inc is seeking a DRG Coding Auditor specialized in MS-DRG and APR-DRG to audit inpatient medical records and generate high-quality recoverable claims across lines of business. The role requires advanced ICD-10 coding expertise, clinical guideline...Remote jobWork from home
- ...Healthcare's Parallon is seeking a work-from-home Inpatient Coding Auditor to perform internal quality assessments of coding across the... ...Center (HSC). You will review outcomes to improve accuracy, integrity and data quality while ensuring compliance with national guidelines...Remote jobWork from home
$22.78 - $29.62 per hour
Location Remote - Florida US:FL:Fort Myers Department Department of Revenue Integrity Work Type Full Time Shift Shift 1/7:00:00 AM to 3:30:00 AM Minimum to Midpoint Pay Rate... ...certification preferred to include CPT, HCPCS, ICD9-10, and DRG #J-18808-Ljbffr Remote JobsRemote workFull timeShift work- UnitedHealth Group seeks a Healthcare System Revenue Cycle Compliance Auditor to plan and perform audits across the revenue cycle, ensuring regulatory adherence and strong controls. You will collaborate with compliance leaders and business units to deliver actionable findings...Remote job
- Amazon One Medical is seeking a Coding Compliance Auditor to strengthen the Revenue Cycle team. You will audit coding accuracy, ensure regulatory compliance, and drive process improvements across clinical and coding operations. The role emphasizes autonomy, problem solving...Remote job
- Commonwealth of Pennsylvania, Bureau of Audits, Altoona Regional Office, seeks a Revenue Tax Auditor to conduct field audits and ensure compliance with state tax laws. You will plan, review records, and communicate findings to taxpayers, supporting fair tax practices across...Remote jobPart timeWork at officeMonday to Friday
- ...application for the opportunity below: DRG Validation Auditor Schedule: Monday-Friday Day Shift... ...in appropriate reimbursement and data integrity. You will review outcomes are communicated... .... Parallon provides full-service revenue cycle management, or total patient account...Temporary workWork from homeMonday to FridayFlexible hoursDay shift
$58k - $78k
...Auditor, Revenue Optimization Sunrise,FL - USA Responsibilities Audit medical records to identify missed charges, incorrect coding, and other inconsistencies that result in missed billing opportunities. Perform Root Cause Analyses and report findings that...Remote jobFlexible hours
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