Diagnosis-Related Group Manager

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🕒 6 days ago

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EXL

WebsiteLinkedInAll Job Openings

10,000+ employees

💰 $2M Venture Round on 2015-01

Choosing a digital partner is about more than capabilities — it’s about collaboration and character.

📋 Description

• Lead the planning, coordination, and execution of DRG audit activities • Manage a team of auditors responsible for MS-DRG and APR-DRG reviews • Oversee inventory, aging, risks, and day-to-day performance • Collaborate cross-functionally to support program success • Ensure accurate coding and reimbursement outcomes • Monitor regulatory and payer guideline updates, ensuring audits remain compliant

🎯 Requirements

• CCS, RHIT, RHIA preferred • 5–8 years of experience with MS-DRG and APR-DRG, including strong knowledge of ICD-10-CM/PCS and Official Coding Guidelines • Prior experience leading teams or acting in a supervisory capacity • Strong understanding of DRG reimbursement methodologies • Knowledge of Medicare, Medicaid, and commercial payer guidelines • Experience working in audit or payment integrity operations • Strong analytical skills with ability to identify trends and support decision-making • Effective communication and interpersonal skills • Proficiency in Microsoft Office and audit/reporting systems

🏖️ Benefits

• Up to 10% annual travel • Competitive benefits package, including healthcare, vision, dental, and 401(k) options