DRG Validation Auditor I

🕒 July 10

🇺🇸 United States – Remote

💵 $48.1k - $81.2k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔎 Auditor

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 28%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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R1 RCM

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 2017

💼 Consulting

📦 Logistics

🏥 Healthcare

💰 Private Equity Round on 2024-07

Consulting • Logistics • Healthcare

R1 RCM is a leading provider of revenue cycle management solutions for the healthcare industry. With an emphasis on maximizing financial performance and optimizing patient care, R1 offers a comprehensive platform that integrates data analytics, intelligent technologies, and deep expertise in revenue cycle management. The company assists healthcare providers—ranging from hospitals and health systems to physician and specialty care practices—in capturing revenue opportunities, improving payer and patient cash flows, and ensuring compliance with government regulations. R1 is committed to driving cost reductions and revenue improvements while enhancing the patient experience. Their suite of services includes revenue recovery, clinical integrity, and regulatory navigation, making them a trusted partner for many top healthcare providers.

📋 Description

• Audit inpatient cases for DRG validation and/or documentation improvement • Review accounts in proprietary software and client EMR systems to validate accounts • Review inpatient medical records for validation of DRG assignment • Provide detailed rationale and supporting evidence for recommendations and findings • Use industry-recognized references, including ICD-10 Official Guidelines for Coding and Reporting, AHIMA Standards of Ethical Coding, AHIMA Practice Briefs related to compliant querying, and AHA Coding Clinics

🎯 Requirements

• Current AHIMA credential of one or more of: RHIA, RHIT, and/or CCS required • 3+ years of ICD-10 coding and DRG reimbursement experience • Recent acute inpatient auditing experience • Experience with multiple EMR systems such as Epic, Cerner, and Meditech

🏖️ Benefits

• Annual bonus plan at a target of 5.00% • Competitive benefits package • Opportunities to constantly learn, collaborate across groups, and explore new career paths • Opportunities to contribute, think boldly, and create meaningful work • Reasonable accommodation for applicants with disabilities