DRG Coding Auditor
Role Description The DRG Coding Auditor is a part-time, remote role with flexible scheduling, responsible for reviewing inpatient medical records to validate DRG assignment, ICD-10-CM/PCS coding, and related documentation. Day-to-day activities include conducting detailed coding audits, identifying variances, and summarizing findings in clear, objective reports. Responsibilities also include monitoring regulatory and payer updates, supporting education on coding guidelines, and contributing to process improvements that enhance a defense of coding accuracy and compliance. The role requires consistent adherence to confidentiality standards and timely completion of assigned audit workload. Employee or contract positions available.
Qualifications
- Strong knowledge of inpatient DRG methodologies, ICD-10-CM/PCS coding guidelines, and reimbursement regulations.
- Experience performing chart reviews, coding quality audits, and documentation integrity assessments in an acute care setting.
- Ability to analyze data, identify patterns or trends, and translate findings into clear, actionable recommendations.
- Proficiency with electronic health records (EHRs), encoder software, and standard office productivity tools.
- Excellent written and verbal communication skills
. Proficiency with Microsoft Office programs
- Strong attention to detail, critical thinking abilities, and commitment to ethical and compliant coding practices.
- Ability to work independently in a remote environment, manage competing priorities, and meet deadlines consistently.
- Certified coding credentials such as CCS, CIC, or equivalent; prior DRG auditing experience is highly preferred.
- Familiarity with Medicare regulations, payer policies, and official coding guidelines (AHA Coding Clinic, CMS, etc.).
- Ongoing interest in professional development and staying current with changes in coding and compliance requirements.