Medical Director, DRG Audit & AI Innovation

Perform high-quality DRG clinical reviews, ensuring diagnostic and coding accuracy for hospital claims. You will work with our product and engineering teams to refine how our AI agent learns from medical director decision-making. By blending expert review with feedback into the AI system, transform traditional audits into seamless, AI-powered adjudication that can scale across the healthcare landscape. Your responsibilities include conducting DRG reviews, applying industry standard guidelines, translating case-based reasoning into structured feedback for the AI adjudicator, and serving as a subject matter expert for coding teams. This role also involves participating in quality improvement initiatives to enhance reviewer consistency and platform performance.