EnableComp provides specialty revenue cycle management solutions for healthcare organizations, helping hospitals, health systems, and ambulatory surgery centers improve reimbursement accuracy and financial sustainability.
The DRG Auditor reviews post-billed inpatient claims to identify missed reimbursement opportunities, validate diagnosis and procedure coding, and support accurate DRG reimbursement. The role works within a specialized DRG database, analyzes medical records, and makes recommendations for reimbursement improvements based on coding accuracy and clinical documentation.
Requirements & Qualifications
Qualifications
- Associate's or bachelor's degree in health information management or a related field required
- Certified Coding Specialist (CCS) certification required
- 2–3 years of experience in DRG validation, inpatient medical coding, or related coding review
- Strong understanding of ICD-10-CM/PCS coding guidelines, DRG reimbursement methodology, and hospital billing processes
- Ability to read and interpret clinical documentation across multiple departments, including nursing, operative, radiology, and pharmacy
- Experience in a post-bill coding environment with familiarity using DRG grouping software and billing databases
- Strong analytical skills with a focus on reimbursement accuracy and financial impact
- Comfortable working across EMRs, digital platforms, and data systems
- Proficient in Microsoft Word, Excel, and Outlook
Additional expectations
- Able to work independently in a detail-oriented, data-driven environment
- Strong written and verbal communication skills
- Ability to manage high-volume workloads and competing priorities
- High integrity when handling PHI and confidential information
Location
N/A
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
Yes
Posted
3 weeks ago
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