• Inpatient DRG Coding

    Emory Healthcare/Emory University (Atlanta, GA)
    …mentorship, development, leadership programs and more! **Description** We are seeking an experienced ** Inpatient DRG Coding Auditor ** to extract data ... the accuracy of DRGs. This individual will: + Reviews inpatient medical records for select payer populations post-discharge and...an acute care setting. + Previous experience in performing DRG coding audits. + Possesses knowledge of… more
    Emory Healthcare/Emory University (09/05/25)
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  • DRG Coding Auditor

    Elevance Health (Chicago, IL)
    ** DRG CODING AUDITOR ** **_Virtual_**...medical-expense spending. The ** DRG CODING AUDITOR ** is responsible for auditing inpatient medical ... DRG assignment accuracy. Specializes in review of DRG coding via medical record and attending...Registered Health Information Technician and/or CCS as a Certified Coding Specialist and/or CIC as a Certified Inpatient more
    Elevance Health (10/03/25)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Denver, CO)
    …(CCDS), Certified Documentation Improvement Practitioner (CDIP), Certified Professional Coder (CPC) or Inpatient Coding Credential such as CCS or CIC. + ... **Diagnosis Related Group Clinical Validation Auditor -RN (CDI, MS- DRG , AP- DRG ...Experience with third party DRG Coding and/or Clinical Validation Audits or… more
    Elevance Health (09/23/25)
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  • DRG Denials Auditor

    Community Health Systems (Franklin, TN)
    **Job Summary** The DRG Denials Auditor conducts hospital inpatient DRG denial audits for both RAC and non-RAC accounts, reviewing patient records for ... discharge disposition, and any other relevant data to ensure coding accuracy. The auditor is also responsible...coding practices and compliance. **Essential Functions** + Performs inpatient denial reviews using ICD-10-CM/PCS and DRG more
    Community Health Systems (09/09/25)
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  • DRG Auditor - November Class

    Insight Global (South Jordan, UT)
    … knowledge ( DRG & ICD-10) Registered Nurse RN (must be inpatient ) WITH coding /clinical documentation certification (2 years in clinical documentation) OR ... Job Description Insight Global is seeking a DRG Validation Auditor for one of...extensive background in either facility-based nursing, clinical documentation, and/or inpatient coding and has a high level… more
    Insight Global (09/18/25)
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  • Inpatient Medical Coding

    Humana (Boise, ID)
    …of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical ... caring community and help us put health first** The Inpatient Medical Coding Auditor extracts...least one of these qualifications for 4 years) * MS- DRG coding /auditing experience * Experience reading and… more
    Humana (09/24/25)
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  • Coding Auditor Educator-…

    Highmark Health (Nashville, TN)
    …HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding , DRG /APC structure according to regulatory requirements. Reports findings both ... Health Network **Job Description :** **_*This role will cover Inpatient Auditors and will require Inpatient (AHIMA)...In-depth knowledge of ICD CM, ICD PCS and CPT/HCPCS coding systems. Must be proficient in DRG /APC… more
    Highmark Health (09/20/25)
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  • Inpatient Coding Quality…

    HCA Healthcare (Caldwell, ID)
    …We want you to apply! **Job Summary and Qualifications** As a work from home Inpatient Coding Auditor , you will be responsible for performing internal ... is recognized. Submit your application for the opportunity below: Inpatient Coding Quality Auditor Parallon....a fully work from home position.** **This position requires Inpatient Coding and DRG Validation… more
    HCA Healthcare (09/27/25)
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  • Inpatient Medical Coding

    Cognizant (Nashville, TN)
    **About the role** As an Inpatient Medical Coding Auditor , you will make an impact by auditing consultant inpatient . You will be a valued member of the ... teams. **In this role, you will:** + Review ICD-10 inpatient patient records for accuracy and compliance + Review...and ICD-10-PCS education and mentoring to Company's clients in coding , billing and compliance + Perform Peer Reviews of… more
    Cognizant (09/23/25)
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  • Coding Auditor Inpatient

    AdventHealth (Orlando, FL)
    … Quality Manager, the Data Quality Reviewer is responsible for validating the coding performed by inpatient or outpatient coders. Random and/or target samples ... + Performs quality reviews on coded records to validate ICD-10, ICD-10-PCS, MS- DRG , APR-DRGs, and overall coding accuracy retrospectively and concurrently. +… more
    AdventHealth (09/11/25)
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  • Divisional Coding Quality Auditor

    AdventHealth (Altamonte Springs, FL)
    …: Remote **The role you will contribute:** The inpatient or outpatient coding team Corporate Quality Auditor (QA)/Educator supports the operations of the ... + Expert level knowledge of Medicare Severity Diagnosis-Related Groups (MS- DRG ), and All Patient Refined Diagnosis-Related Groups (APR ...**Preferred Qualifications:** 5 of inpatient or outpatient coding or Coding Quality Auditor more
    AdventHealth (09/17/25)
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  • Coding Quality Auditor

    Houston Methodist (Houston, TX)
    At Houston Methodist, the Coding Quality Auditor position is responsible for ensuring accuracy in code assignment of diagnosis and procedure to outpatient and/or ... **SERVICE ESSENTIAL FUNCTIONS** + Responds promptly to internal and external customer coding / DRG requests. Responds promptly to Business Office requests to code… more
    Houston Methodist (09/30/25)
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  • Clinical Documentation Specialist Auditor

    UNC Health Care (Chapel Hill, NC)
    …Abilities Requirements:** * Strong knowledge of ICD-10-CM, ICD-10-PCS, and CPT coding , MS DRG , hierarchical condition categories (HCC), and CDI ... the unique communities we serve. Summary: This positon trains and audits Inpatient and Outpatient Clinical Documentation Specialists (CDS) across all HCS entities… more
    UNC Health Care (07/29/25)
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  • Clinical Coding Auditor & Trainer

    Centene Corporation (New York, NY)
    …Group ( DRG ) and Medical Record Audit Programs for Fidelis Care. The Clinical Coding Auditor & Trainer position is primarily remote with a small travel ... with all policies and standards **Highly Preferred Skills:** + Inpatient Coding Experience + At least 1...degree in Nursing or equivalent experience. 4+ years of DRG and/or Medical Record Audit experience. One year of… more
    Centene Corporation (09/27/25)
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  • (RN) Registered Nurse Coding Auditor

    Northwell Health (Westbury, NY)
    …6.Reviews codes on Medicare/non-Medicare charts for compliance to rules and conventions. 7.Communicates DRG changes and rationale to the coding and CDI staff. ... **Req Number** 155044 Job Description Validates Acute Inpatient coded charts to ensure the diagnostic information leading to the assignment can be substantiated by… more
    Northwell Health (10/03/25)
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  • Compliance Auditor , Associate

    UPMC (Pittsburgh, PA)
    …Modifiers, etc.). + Knowledge of coding /classification systems appropriate for inpatient /outpatient, DRG prospective payment system or office setting E/M ... auditing, billing and compliance. + Knowledge of CMS and third-party payer coding , billing, and documentation compliance regulations preferred (MS- DRG , APR-… more
    UPMC (07/24/25)
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  • Compliance Auditor , Intermediate (Cemc,…

    UPMC (Pittsburgh, PA)
    …Modifiers, etc.). + Knowledge of coding /classification systems appropriate for inpatient /outpatient, DRG prospective payment system or office setting E/M ... auditing and compliance. + Extensive knowledge of CMS, and third-party payer coding , billing, and documentation compliance regulations required (MS- DRG , APR-… more
    UPMC (09/04/25)
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  • Risk Adjustment Clinical Auditor /Analyst

    UPMC (Pittsburgh, PA)
    …rules. Accurately review the assigned HCC diagnosis codes and apply the appropriate inpatient or outpatient coding guidelines, AHA coding clinics, ICD-10-CM ... has an exciting opportunity for a Risk Adjustment Clinical Auditor /Analyst position in the Medicare department. This is a...of clinical experience. + Two years of either HCC coding , reviews or education, DRG experience, Clinical… more
    UPMC (09/30/25)
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  • Analyst, Configuration Oversight (Claims…

    Molina Healthcare (Iowa City, IA)
    …all claim types of reimbursements not limited to payment methodologies such Stoploss, DRG , APC, RBRVS, FFS applicable for HD Inpatient , Outpatient and ... and services billed under Institutional and non-institutional claims. * Validates coding , updating and maintaining benefit plans, provider contracts, fee schedules… more
    Molina Healthcare (09/17/25)
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  • Coding Educator FT-Katy CC (Hybrid)

    Houston Methodist (Houston, TX)
    …(for inpatient /outpatient coding ) coding classification systems + For inpatient /outpatient coding : MS- DRG , APR DRG and APC assignment systems ... professional teaching/training experience **LICENSES AND CERTIFICATIONS - REQUIRED** + For inpatient /outpatient coding : RHIT, RHIA, or CCS certification from… more
    Houston Methodist (07/23/25)
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