Senior DRG Auditor (Disputes)

Key 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.

Qualifications:

• 6+ years experience performing MS-DRG and ARP-DRG reviews for a Payment Integrity vendor or Payer.
• Active certified coder credential (e.g., CIC, CPC, CCS, RHIA, or RHIT) required; CCS highly preferred.
• Self-motivated and able to work independently in a remote environment while maintaining high performance.

Benefits:

• Fully remote opportunity with about 5% travel.
• Medical, dental, vision, life, disability insurance, and Employee Assistance Program.
• 401K retirement plan with company match; flexible spending and health savings account; Flex Time Off + company holidays; up to 14 weeks of paid parental leave.