Drg Coding Auditor

Elevance Health Chicago, Illinois, US

About the Role

Elevance Health is seeking a DRG Coding Auditor to ensure accurate, compliant inpatient reimbursement and support whole-health care for our members. In this remote role, you will perform detailed retrospective and prospective DRG audits, reviewing medical records and ICD-10-CM/PCS codes to validate MS-DRG/APR-DRG assignments and identify documentation gaps. You'll collaborate with coders, clinicians, and compliance teams, prepare clear audit reports, and deliver education that improves coding quality. Join a mission-driven, inclusive culture with strong benefits, growth opportunities, and a focus on innovation, learning, and work-life balance.

Responsibilities

  • Perform retrospective and prospective DRG audits to validate MS-DRG/APR-DRG assignments
  • Review medical records and ICD-10-CM/PCS codes for accuracy
  • Prepare audit reports and provide education to improve coding quality

Qualifications

  • BSN or coding credential preferred
  • experience in medical coding and auditing
  • knowledge of DRG systems and ICD-10-CM/PCS

Required Skills

DRG coding auditing medical coding ICD-10-CM/PCS MS-DRG/APR-DRG

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