Diagnosis Related Group DRG Auditor III at DS Technologies Inc in MI-Detroit-48127 Fully Remote - US

Job description

• DS Technologies Inc is looking for Diagnosis-Related Group (DRG) - Auditor III, Healthcare role for one of our premier clients.
• Job Title: Diagnosis-Related Group (DRG) - Auditor III, Healthcare
• Location: Remote
• Experience: 4+ Years
• Employment Type: Full Time
• Job Description

Responsibilities

• ✔Conduct comprehensive MS-DRG and APR-DRG coding reviews to ensure accuracy in DRG assignment and reimbursement.
• ✔Apply expert knowledge of coding guidelines and utilize industry-leading tools to maximize overpayment identifications.
• ✔Craft clear, concise, and well-supported audit findings, backed by AHA Coding Clinic Guidelines and ICD-10-CM/PCS regulations.
• ✔Utilize advanced DRG encoder tools (such as 3M, Webstrat) to drive efficiency and accuracy in audits.
• ✔Meet or exceed EXL’s quality and productivity standards, including strong uphold rates for appeals.
• ✔Stay ahead of industry trends, coding updates, and compliance regulations to maintain expert-level knowledge.
• ✔Adhere to HIPAA and EXL policies and procedures to ensure data security and regulatory compliance.

Requirements

• Minimum High School Diploma (Higher education preferred).
• CCS, RHIA, or RHIT credential (Multiple credentials preferred).
• 4+ years of MS-DRG/APR-DRG coding experience with a deep understanding of AHA Coding Guidelines and DRG reimbursement methodologies.
• Prior experience in DRG retrospective overpayment identification auditing is highly desirable.
• Strong proficiency with DRG encoder tools (3M, Webstrat).
• ✅Expert-level inpatient coding knowledge with an in-depth understanding of ICD-10-CM/PCS coding guidelines.
• ✅Self-motivated and able to work independently in a remote environment while maintaining high performance.
• ✅Exceptional time management, problem-solving, and analytical skills.
• ✅Strong written and verbal communication with attention to detail.
• ✅Proficient in Excel, Word, and OneNote, with strong overall computer literacy.
• ✅Passion for DRG auditing and a commitment to teamwork, collaboration, and continuous learning.

Skills

Required

• Self-motivated
• Time management
• Problem-solving
• Analytical skills
• Written and verbal communication
• Attention to detail
• Teamwork
• Collaboration
• Continuous learning
• MS-DRG/APR-DRG coding
• AHA Coding Guidelines
• ICD-10-CM/PCS coding guidelines

Benefits

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Paid time off
• Compensation: $70,000.00 - $90,000.00 per year