Diagnosis Related Group; DRG Auditor III

Join to apply for the Diagnosis Related Group (DRG) Auditor III role at EXL Health

6 days ago Be among the first 25 applicants

Join to apply for the Diagnosis Related Group (DRG) Auditor III role at EXL Health

This range is provided by EXL Health. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

$70,000.00/yr - $80,000.00/yr

Direct message the job poster from EXL Health

Join Our Team as a DRG Auditor III – Make an Impact in Healthcare!

Are you a passionate and experienced DRG Auditor looking for an opportunity to thrive in a dynamic, innovative environment? EXL USA Healthcare is seeking a DRG Auditor III to join our team!

This role offers a fully remote work experience with possible 10% travel per year. The rest of the time, you'll enjoy the flexibility of working from your home office.

Why EXL?

At EXL, we believe in fostering an environment where our employees can learn, grow, and succeed. We provide industry-leading training, career development opportunities, and a competitive benefits package to ensure you can focus on what you do best—delivering excellence in DRG auditing. If you're looking for a role where you can make a real impact while maintaining work-life balance, this is it!

What You’ll Do:

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 over payment 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.

What We’re Looking For:

• Minimum High School Diploma (Higher education preferred).
• CCS, RHIA, or RHIT credential (Multiple credentials preferred).

Experience & Expertise:

• 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 over payment 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 One Note, with strong overall computer literacy.

Passion for DRG auditing and a commitment to teamwork, collaboration, and continuous learning.

What We Offer:

A fast-paced, innovative environment with a team of industry-leading experts.

Hands-on experience with top-tier clients in the healthcare industry.

Mentorship and career development programs to help you grow professionally.

A strong culture of collaboration, support, and inclusivity.

Competitive benefits package, including healthcare, vision, dental, and 401(k) options.

Ready to Take Your Career to the Next Level?

• Seniority level
  
  Mid-Senior level

• Employment type
  
  Full-time

• Job function
  
  Health Care Provider
• Industries Hospitals and Health Care

Referrals increase your chances of interviewing at EXL Health by 2x

Medical insurance

Vision insurance

401(k)

Paid maternity leave

Paid paternity leave

Apply BELOW