• Inpatient DRG Reviewer

    Zelis (FL)
    …personal interests that shape who you are. Position Overview The Inpatient DRG Reviewer will be primarily responsible for conducting post-service, pre-payment and ... post pay comprehensive inpatient DRG reviews based on industry standard inpatient coding guidelines...criteria plan, and policy exclusions. Conduct reviews on inpatient DRG claims as they compare with medical records ICD-10… more
    Zelis (09/27/25)
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  • DRG Specialist II

    UPMC (Pittsburgh, PA)
    UPMC Corporate Revenue Cycle is hiring a DRG Specialist II to join our coding team! This opportunity works Monday through Friday during daylight hours. The position ... will be fully remote! In this role, the DRG Specialist II will review clinical documentation within the...episode of care. + Review and evaluate focused UPMC DRG medical records for accurate DRG assignment… more
    UPMC (09/25/25)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Denver, CO)
    **Diagnosis Related Group Clinical Validation Auditor-RN (CDI, MS- DRG , AP- DRG and APR- DRG )** **Virtual:** This role enables associates to work virtually ... (local time) The **Diagnosis Related Group Clinical Validation Auditor-RN (CDI, MS- DRG , AP- DRG and APR- DRG )** is responsible for auditing inpatient medical… more
    Elevance Health (09/23/25)
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  • Inpatient DRG Coding Auditor

    Emory Healthcare/Emory University (Atlanta, GA)
    …leadership programs and more! **Description** We are seeking an experienced **Inpatient DRG Coding Auditor** to extract data from patient encounters ensuring the ... the accuracy and completeness of diagnosis and procedure coding, DRG assignment, and abstracted data POA, Discharge Disposition. +...+ Reviews discrepancies between the Clinical Documentation Specialist (CDS) DRG and the Coder DRG . + Reviews… more
    Emory Healthcare/Emory University (09/05/25)
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  • DRG Auditor - November Class

    Insight Global (South Jordan, UT)
    Job Description Insight Global is seeking a DRG Validation Auditor for one of our clients to sit 100% remote. This person should have an extensive background in ... of understanding of reimbursement guidelines specifically an understanding of the MS- DRG , AP- DRG , and APR- DRG payment systems. This position is responsible… more
    Insight Global (09/18/25)
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  • Facility Coding Inpatient DRG Quality

    Banner Health (AR)
    …quality in the Inpatient Facility Coding department. If you have experience with DRG and PCS coding/denials/audits, we want to hear from you. **Requirements:** + **5 ... facility-based medical coding (clearly reflected in your attached resume);** + ** DRG and PCS Coding, Auditing experience;** + **Bachelors degree or equivalent;**… more
    Banner Health (09/06/25)
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  • Clinical Reimbursement Manager; HSO Drg

    Mount Sinai Health System (New York, NY)
    **Job Description** The purpose of DRG validation is to confirm that diagnostic, procedural information, and the discharge status of the beneficiary, as coded and ... 10th Revision (ICD-10-CM and ICD-10-PCS) codes and the Diagnosis Related Groups ( DRG ). The CRM reviews the physician documentation for specificity, completeness and… more
    Mount Sinai Health System (07/17/25)
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  • Manager DRG Coding Validation

    Elevance Health (Roanoke, VA)
    **Manager DRG Coding Validation (Manager Program and Project Management)** **​** **Hybrid 2:** This role requires associates to be in-office **3** days per week, ... recover, eliminate and prevent unnecessary medical-expense spending. The Manager of DRG Coding Audit & Clinical Validation leads a high-performing team responsible… more
    Elevance Health (09/09/25)
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  • Director Clinical and DRG Denials

    Kaleida Health (Buffalo, NY)
    **Director Clinical and DRG Denials** **Location:** Larkin Bldg @ Exchange Street Location of Job: US:NY:Buffalo Work Type: Full-Time **Shift:** Shift 1 Job ... Description **Summary:** The Director, Clinical & DRG Denials provides clinical leadership and administrative guidance to the Clinical Revenue Cycle department.… more
    Kaleida Health (09/17/25)
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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 accuracy ... in ICD-10-CM/PCS coding, DRG assignments, and supporting clinical documentation. This includes evaluating present on admission (POA) indicators, discharge… more
    Community Health Systems (09/09/25)
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