Overview This auditing role will focus on Coding & Clinical Chart Validation for our Inpatient audits (DRG Validation). The ideal candidate for this position needs to have both a clinical (nurse) and a coding / auditing background
About Us: Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to
Overview This auditing role will focus on Coding & Clinical Chart Validation for our Inpatient audits. The ideal candidate for this position needs to have both a clinical (nurse) and a coding / auditing background focused
EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations, leveraging over 24 years of industry-leading expertise and its unified E360 RCM intelligent automation platform to improve financial sustainability for hospitals, health systems, and ambulatory surgery
Position Summary: As a valued member of the DRG Review Team, the DRG Integrity Specialist performs a secondary level review of medical records and code assignment using knowledge of Accuity technology and client systems with a physician in
You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive
EXL USA Healthcare is seeking an IRF Auditor III to join our team. This role offers a fully remote work experience with possible 10% travel per year for team meetings and limited client onsite engagements. The
This role offers a fully remote work experience with possible 10% travel per year. The rest of the time, youll enjoy the flexibility of working from your home office. Why EXL? At EXL, we believe in
You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive
It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your
About Us: Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to
EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations, leveraging over 24 years of industry-leading expertise and its unified E360 RCM intelligent automation platform to improve financial sustainability for hospitals, health systems, and ambulatory surgery
The DRG Manager leads the planning, coordination, and execution of DRG audit activities, ensuring teams meet client SLAs and operational goals. This role oversees inventory, aging, risks, and day-to-day performance, while collaborating cross-functionally to support program success. The
In this fully remote position as a new graduate, you will have the opportunity to develop your skills in auditing and compliance while working with a talented team. The successful candidate will review outpatient medical records
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves
Anticipated End Date:2026-08-31 Position Title:DRG Coding Auditor - MS-DRG and APR-DRG Job Description: DRG Coding Auditor - MS-DRG and APR-DRG Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy.
Overview Empower AI is AI for government. Empower AI gives federal agency leaders the tools to elevate the potential of their workforce with a direct path for meaningful transformation. Headquartered in Reston, Va., Empower AI leverages
Opportunity Overview We are seeking a Senior Inpatient Auditor to join our dynamic Payment Integrity team. This critical role involves conducting comprehensive MS-DRG and APR-DRG coding reviews to ensure the accuracy of claims and maximize overpayment identification. If
Clinical Documentation Integrity Drg Downgrade Specialist The Clinical Documentation Integrity DRG Downgrade Specialist is responsible for reviewing, analyzing, and responding to payer-initiated DRG downgrades. The Clinical Documentation Integrity DRG Downgrade Specialist ensures accurate DRG assignment, protects revenue integrity, and supports compliant