DRG Validation Coding Auditor Job at Robert Half (Cincinnati)

Inpatient DRG Nursing Auditor

Join our team in Manila as Inpatient DRG Nursing Auditor. If you’re a registered...

Location

Philippines , Taguig City

Salary:

Not provided

Access Healthcare LLC

Expiration Date

Until further notice

Requirements

Good Comprehension skills
Strong attention to detail and communication skills
Curious and willing to ask relevant questions
Ability to understand client guidelines related to insurance advantage claims
Must be Philippine Registered Nurse with Active license
Must have an experience in clinical and audit in IP DRG

Job Responsibility

Conduct initial audit reviews to validate billed diagnoses and DRG code are supported by medical records
Record audit results and document finding notes based on policies using professional clinical resources
Perform provider appeals reviews and render decision to either uphold or overturn original finding
Review questionable encoder results, complex cases, and appeal reviews to facilitate referrals to clinical department as needed
Propose new audit concepts supported by your research and analysis
Define new audit concept criteria and test and validate new concepts developed by analytics team
Escalate facility issues per client guidance

Inpatient/DRG Validation Coding Auditor

The Inpatient/DRG Validation Coding Auditor is responsible for reviewing acute i...

Location

United States , Sharonville

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

5+ years inpatient coding experience
3+ years facility coding audit experience (DRG/APC validation)
Strong knowledge of reimbursement methodologies and DRG payment systems
Proficiency in EMRs, encoders, proprietary audit systems, and Microsoft Office
Deep understanding of HIPAA and confidentiality requirements
Strong analytical, written, and verbal communication skills
Solid grasp of medical and surgical terminology
Bachelor’s Degree or equivalent experience
Required certification (CCS preferred): CPC (Certified Professional Coder)
CCS (Certified Coding Specialist)

Job Responsibility

Perform detailed audits of inpatient records to validate ICD-10-CM/PCS coding, DRG assignment (MS-DRG, APR-DRG, TRICARE), and clinical documentation accuracy
Ensure documentation supports coded diagnoses, procedures, severity of illness, and resource utilization
Identify overpayments and underpayments through claim analysis (including 30-day lookbacks)
Provide clear, compliant audit recommendations aligned with Official Coding Guidelines and AHA Coding Clinics
Partner with CDI specialists to identify documentation improvement and query opportunities
Maintain productivity, quality standards, and client turnaround expectations
Stay current on regulatory changes, reimbursement policies, and coding updates
Contribute to process improvement initiatives and compliance risk identification

What we offer

medical
vision
dental
life and disability insurance
company 401(k) plan

Inpatient/DRG Validation Coding Auditor

The Inpatient/DRG Validation Coding Auditor is responsible for reviewing acute i...

Location

United States , Sharonville

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

5+ years inpatient coding experience
3+ years facility coding audit experience (DRG/APC validation)
Strong knowledge of reimbursement methodologies and DRG payment systems
Proficiency in EMRs, encoders, proprietary audit systems, and Microsoft Office
Deep understanding of HIPAA and confidentiality requirements
Strong analytical, written, and verbal communication skills
Solid grasp of medical and surgical terminology
Bachelor’s Degree or equivalent experience
Required certification (CCS preferred): CPC (Certified Professional Coder)
CCS (Certified Coding Specialist)

Job Responsibility

Perform detailed audits of inpatient records to validate ICD-10-CM/PCS coding, DRG assignment (MS-DRG, APR-DRG, TRICARE), and clinical documentation accuracy
Ensure documentation supports coded diagnoses, procedures, severity of illness, and resource utilization
Identify overpayments and underpayments through claim analysis (including 30-day lookbacks)
Provide clear, compliant audit recommendations aligned with Official Coding Guidelines and AHA Coding Clinics
Partner with CDI specialists to identify documentation improvement and query opportunities
Maintain productivity, quality standards, and client turnaround expectations
Stay current on regulatory changes, reimbursement policies, and coding updates
Contribute to process improvement initiatives and compliance risk identification

What we offer

medical
vision
dental
life and disability insurance
company 401(k) plan

Remote Inpatient/DRG Validation Coding Auditor

Our company is searching for a Remote Inpatient/DRG Validation Coding Auditor to...

Location

United States , Indianapolis

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Minimum of 5 years of recent inpatient coding experience
At least 3 years of acute inpatient coding audit experience
Active CIC (Certified Inpatient Coder) certification
Deep knowledge of DRG payment and reimbursement systems (MS-DRG, APR-DRG, Tricare, etc.)
Proven ability to independently interpret complex medical records, identify documentation gaps, and communicate required improvements
Strong written and verbal communication skills

Job Responsibility

Perform comprehensive audits of all acute inpatient medical records to identify coding errors, compliance concerns, and educational opportunities
Interpret, evaluate, and apply ICD-10-CM/PCS coding principles and guidelines to ensure documentation adequately supports the coded diagnoses and procedures
Verify that assigned DRGs accurately reflect patient severity and resource utilization according to MS, APR, Tricare, and related payment methodologies
Research regulatory requirements and provide clear, well-supported recommendations in audit reports
Collaborate with Clinical Documentation Integrity (CDI) specialists to pinpoint and communicate documentation and/or physician query opportunities
Write concise, constructive feedback and educational notes for coders, referencing the latest official coding guidelines and AHA Coding Clinics
Maintain established productivity and quality standards as measured by audit leadership

What we offer

medical
vision
dental
life and disability insurance
401(k) plan

Fulltime

Receptionist

We are looking for a detail-oriented Receptionist to join our team in Miami, Flo...

Location

United States , Miami

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Proficiency in using a multi-line phone system for managing calls
Strong customer service skills with the ability to handle inquiries professionally
Experience in data entry with attention to detail and accuracy
Ability to communicate effectively through email correspondence
Excellent interpersonal skills to interact with staff and visitors
Competence in Microsoft Excel, Outlook, and Word for administrative tasks
Organizational skills to manage files and maintain office order
Capability to schedule appointments and coordinate meetings efficiently

Job Responsibility

Oversee access to the office, ensuring security and proper protocols are followed
Manage the stocking and organization of supplies in the kitchens to maintain efficiency
Maintain the cleanliness and orderliness of the office environment to ensure a neat appearance
Handle incoming phone calls using a multi-line phone system, providing courteous and efficient service
Assist with scheduling appointments and coordinating meetings as needed
Perform accurate data entry tasks to support administrative functions
Organize and maintain files, ensuring easy accessibility and proper documentation
Communicate effectively via email to address inquiries and provide information
Execute various ad hoc projects and tasks as assigned to support office operations

What we offer

medical, vision, dental, and life and disability insurance
eligible to enroll in our company 401(k) plan

Psychiatrist

Astrya Global, a San Diego–based medical staffing agency, is hiring Psychiatrist...

Location

United States , San Bernardino

Salary:

Not provided

Astrya Global

Expiration Date

Until further notice

Requirements

Active CA licensure
Board certification
Active CA DEA
New graduates eligible

Job Responsibility

Evaluate and diagnose mental health disorders
Develop and implement treatment plans
See 15+ patients per day completing initial and follow up appointments
Prescribe and refill medications
Collaborate with up to 4 NPs as needed

What we offer

Malpractice Insurance
Weekly pay
Full-service credentialing and licensing department
Dedicated corporate travel team with airfare, car rental and hotel booking
Referral Bonus up to $5,000

Fulltime

Cook

Boston Pizza Cooks are the engine of the entire restaurant! They are responsible...

Location

Canada , Campbell River

Salary:

17.85 - 22.00 CAD / Hour

Boston Pizza

Expiration Date

Until further notice

Requirements

Collaborative
Team Player
Multi Tasker
Self-Starter
Detail Oriented
Efficient

Job Responsibility

Creating delicious menu items perfectly every time for every guest
Ensuring Guests have an excellent Boston Pizza experience from start to finish
Championing a fun and safe work environment
Contributing to a thriving workplace culture
Works alongside their team members
Builds relationships by finding common ground and working cohesively with all team members
Committed to championing the 'Heart of Hospitality', Boston Pizza's Brand Standards and Food Safety
Dedicated to providing Perfect Food Every Time to our Guests
Maintains composure and thrives in a fast pace environment
Works with a sense of purpose and always prioritize Guest’s orders

What we offer

Flex scheduling, days or nights
A discount on Canada's best gourmet pizza
A company entrenched in community service with opportunities to give back
Staff parties, pizza recipe contests etc
Work as part of an amazing team
BPI Scholarship Awards
Flexible scheduling that fits your lifestyle and contributes to your life-work balance
Exciting opportunities for career growth within the restaurant or at Boston Pizza head office
Build relationships and give back to your local community
Boston Pizza Scholarship Program

Specialist Education Support Assistant

Are you looking to get into supply or long‑term school-based support work? Are y...

Location

United Kingdom , South Gloucestershire

Salary:

Not provided

AFFINITY WORKFORCE

Expiration Date

Until further notice

Requirements

Hold an Enhanced Child DBS on the Update Service (or be willing to apply through AWS)
Have the ability to develop, encourage and promote learning
Have a passion for making a positive difference to children’s lives
Bring experience working within a UK school environment
Hold a valid safeguarding certificate
Demonstrate strong communication skills with children, staff and parents

Job Responsibility

Delivering targeted interventions
Supporting behaviour and pastoral needs
Helping pupils overcome barriers to learning
Providing lunchtime support

What we offer

Competitive daily rate
Opportunities to gain valuable, varied school experience
Access to exclusive rewards hub offering training, discounts & cashback
Generous referral bonus
Flexible work schedule
Temp-to-perm opportunities
Weekly pay

DRG Validation Coding Auditor

Robert Half

Location:
United States , Cincinnati

Category:
Health and Beauty

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Additional Information:

Job Posted:
March 01, 2026

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Job Description:

Job Responsibility:

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