DRG Coding Auditor; Icd-Cm, Ms-Drg, Ap-Drg, -Drg

Overview

Anticipated End Date:

Position Title: DRG Coding Auditor (ICD-9/10CM, MS-DRG, AP-DRG, APR-DRG)

Job Description: Be Part of an Extraordinary Team

Carelon Payment Integrity is a proud member of the Elevance Health family of companies. Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending.

Build the Possibilities. Make an Extraordinary Impact.

Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
Alternate locations may be considered if candidates reside within a commuting distance from an office.

DRG Coding Auditor: The DRG Coding Auditor is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines of business, and its clients. Also responsible for performing clinical reviews of medical records and other documentation to evaluate issues of coding and DRG assignment accuracy. Specializes in review of DRG coding via medical record and attending physician’s statement sent in by acute care hospitals on submitted DRG.