DRG Auditor, Inpatient ICD-10-CM/PCS

3 days ago

Remote, Oregon, United States LexiCode Full time $60,000 - $120,000 per year

About XBP

XBP Global is a workflow automation leader that leverages decades of industry experience, global footprint and Agentic AI to rethink business process automation and enable digital transformation for our clients. We are approximately 11,000 professionals strong, present across 20 countries, and support over 2,500 clients worldwide.

LexiCode

Remote Inpatient ICD-10-CM/PCS DRG Auditors

Work from home positions

Job Summary-

As a DRG Auditor at LexiCode, you will join a dynamic team of consulting experts dedicated to delivering exceptional audit services to our valued clients.

Pay Disclosure:

LexiCode is required by state specific laws to include the salary range for this role when hiring a resident in applicable locations. The pay range for this position starts at ; however, base pay offered may vary depending on job-related knowledge, skills, and experience. Bonus opportunities may be provided as part of the compensation package, in addition to a full range

Job Description

Essential Functions and Responsibilities

? Performs analysis of medical records and provider claims to validate appropriate DRG and ICD-10-CM/PCS code assignment, including complex medical and surgical cases

? Ensures that assigned codes and DRGs are supported by clinical documentation utilizing payer-specific clinical criteria

? Applies Official Guidelines for Coding and Reporting consistently and appropriately

? Provides detailed written explanations to support or rebut coding/DRG recommendations

Qualifications

Required:

  • RHIA, RHIT, or CCS credential from AHIMA
  • 3 or more years of Inpatient/DRG auditing experience in an acute care setting or payer setting
  • Expertise in ICD-10-CM/PCS, IPPS/MS-DRG and APR-DRG methodology and logic
  • Excellent knowledge of ICD-10-CM/PCS Official Guidelines for Coding and Reporting, AHA Coding Clinics to support audit findings
  • Proficiency in identifying clinical indicators to support documented diagnoses
  • Outstanding computer skills and ability to work in multiple client-specific healthcare systems
  • Excellent written communication and critical thinking skills
  • Ability to efficiently review large volumes of documents with high comprehension level
  • Secure home office environment, compliant with HIPAA and LexiCode's security requirements

Preferred:

  • Experience in a payer coding/clinical DRG audit setting

XBP Global recruiters or representatives will only contact you from emails ending with @xbpamericas, @xbpasia, , , , or We would never ask you for payment or ask you to deposit a cheque into your personal bank account during the recruitment process.

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