CrawlJobs Logo

Inpatient/DRG Validation Coding Auditor

https://www.roberthalf.com Logo

Robert Half

Location Icon

Location:
United States , Sharonville

Category Icon

Job Type Icon

Contract Type:
Not provided

Salary Icon

Salary:

Not provided

Job Description:

The Inpatient/DRG Validation Coding Auditor is responsible for reviewing acute inpatient medical records to ensure accurate coding, compliant documentation, and appropriate DRG assignment. The role focuses on identifying coding errors, ensuring regulatory compliance, optimizing reimbursement, and providing education and feedback to coders and CDI teams.

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

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)
  • RHIA (Registered Health Information Administrator)
  • RHIT (Registered Health Information Technician)
What we offer:
  • medical
  • vision
  • dental
  • life and disability insurance
  • company 401(k) plan

Additional Information:

Job Posted:
March 13, 2026

Job Link Share:

Looking for more opportunities? Search for other job offers that match your skills and interests.

Briefcase Icon

Similar Jobs for Inpatient/DRG Validation Coding Auditor

Inpatient/DRG Validation Coding Auditor

The Inpatient/DRG Validation Coding Auditor is responsible for reviewing acute i...
Location
Location
United States , Sharonville
Salary
Salary:
Not provided
https://www.roberthalf.com Logo
Robert Half
Expiration Date
Until further notice
Flip Icon
Requirements
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
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
What we offer
  • medical
  • vision
  • dental
  • life and disability insurance
  • company 401(k) plan
Read More
Arrow Right

Remote Inpatient/DRG Validation Coding Auditor

Our company is searching for a Remote Inpatient/DRG Validation Coding Auditor to...
Location
Location
United States , Indianapolis
Salary
Salary:
Not provided
https://www.roberthalf.com Logo
Robert Half
Expiration Date
Until further notice
Flip Icon
Requirements
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
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
What we offer
  • medical
  • vision
  • dental
  • life and disability insurance
  • 401(k) plan
  • Fulltime
Read More
Arrow Right
New

Pharmacy Technician

We're building a world of health around every individual — shaping a more connec...
Location
Location
United States , San Antonio
Salary
Salary:
16.00 - 24.00 USD / Hour
https://www.cvshealth.com/ Logo
CVS Health
Expiration Date
July 05, 2026
Flip Icon
Requirements
Requirements
  • Must comply with any state board of pharmacy requirements or laws governing the practice of pharmacy, which includes but is not limited to, age, education, and licensure/certification
  • If the state board of pharmacy does not address or mandate a minimum age requirement, must be at least 16 years of age
  • If the state board of pharmacy does not address or mandate a minimum educational requirement, must have a high school diploma or equivalent, or be actively enrolled in high school or high school equivalency program
  • State-level licensure and national certification requirements vary by state
  • Regular and predictable attendance, including nights and weekends
  • Ability to complete required training within designated timeframe
  • Attention and Focus: Ability to concentrate on a task over a period of time
  • Ability to pivot quickly from one task to another to meet patient and business needs
  • Ability to confirm prescription information and label accuracy, ensuring patient safety
  • Customer Service and Team Orientation: Actively look for ways to help people, and do so in a friendly manner
Job Responsibility
Job Responsibility
  • Living our purpose by following all company SOPs at each workstation to help our Pharmacists manage and improve patient health
  • Following pharmacy workflow procedures at each pharmacy workstation (i.e., production, pick-up, drive-thru, and drop-off) for safe and accurate prescription fulfillment
  • Contributing to positive patient experiences by showing empathy and genuine care: creating heartfelt and personalized moments while serving patients at pick-up, drive-thru, and over the phone
  • keeping patients healthy by offering immunizations and other services at the register and over the phone
  • and demonstrating compassionate care by solving or escalating patient problems
  • Completing basic inventory activities, as permitted by law, and as directed by the pharmacy leadership team, such as accurately putting away medication deliveries and completing cycle counts, returns-to-stocks, waiting bin inventories, etc.
  • Contributing to a high-performing team, embracing a growth mindset, and being receptive to feedback
  • actively seeking opportunities to expand clinical and technical knowledge needed to better assist patients
  • Remaining flexible for both scheduling and business needs, while contributing to a safe, inclusive, and engaging team dynamic
  • voluntarily traveling to stores in the market to work shifts as needed by the business
What we offer
What we offer
  • dental
  • vision
  • wellness resources
  • employee discounts
  • access to certain voluntary benefits
  • other programs
  • Parttime
Read More
Arrow Right
New

Installation Supervisor

National OnDemand, Inc. is a communications and utilities infrastructure provide...
Location
Location
United States , Chase City
Salary
Salary:
Not provided
nationalondemand.com Logo
NATIONAL OnDemand, Inc
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • High School Diploma or equivalent required
  • 1-3 years of leadership experience
  • Possession of valid state issued driver's license required
  • Must be able to pass a background check and drug screen
  • Candidates must have a minimum of five years of experience in a related discipline
  • Proven leadership and teamwork skills fostering an inclusive, supportive environment by motivating and developing staff at all levels
  • Critical thinking and analytical skills, including the capacity to identify, assess and prioritize competing interests and needs
  • Proven ability to adjust quickly to shifting priorities, multiple demands, ambiguity, and rapid change
  • Ability to coordinate and integrate work across multiple disciplines, complete scheduling, and resource planning activities to drive efficient work processes, identify and manage all operational risks, and enhance customer communication and satisfaction
  • Experience managing multiple locations and leading cross-functional teams
Job Responsibility
Job Responsibility
  • Provides technical support, expertise, leadership and accountability for field team
  • Responsible for retention and training needs for field staff
  • Builds and maintains an effective operations organization committed to customer and employee satisfaction and profitable growth
  • Supervise performance of field staff and responds to escalated issues in field
  • Communicate senior management directives to field staff and ensure compliance (Safety, etc.)
  • Develops manpower schedules and loading to ensure contract and workload coverage
  • Site Visits to ensure QC of various projects ensure conformance to client specifications and company requirements
  • Follows up on customer satisfaction issues and drives resolution
  • Onsite support & guidance for technical staff
  • Serves as safety champion for our company
What we offer
What we offer
  • Paid time off (PTO)
  • Medical
  • Dental
  • Vision
  • Short- and long-term disability
  • Life insurance
  • Employee Assistance Program (EAP)
  • 401(k)
  • Fulltime
Read More
Arrow Right
New

Banquet Cook I

The Gaylord Palms Resort & Convention Center is now partnering with the Rouxbe C...
Location
Location
United States
Salary
Salary:
23.00 USD / Hour
https://www.marriott.com Logo
Marriott Bonvoy
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Technical, Trade, or Vocational School Degree
  • At least 3 years of related work experience
Job Responsibility
Job Responsibility
  • Prepare special meals or substitute items
  • Regulate temperature of ovens, broilers, grills, and roasters
  • Pull food from freezer storage to thaw in the refrigerator
  • Ensure proper portion, arrangement, and food garnish
  • Maintain food logs
  • Monitor the quality and quantity of food that is prepared
  • Communicate assistance needed during busy periods
  • Inform Chef of excess food items for use in daily specials
  • Inform Food & Beverage service staff of menu specials and out of stock menu items
  • Ensure the quality of the food items
  • Fulltime
Read More
Arrow Right
New

Banquet Coordinator

Meet group coordinator/host(ess) prior to functions, make introductions, and ens...
Location
Location
Malaysia , Kuala Lumpur
Salary
Salary:
Not provided
https://www.marriott.com Logo
Marriott Bonvoy
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • High school diploma or G.E.D. equivalent
  • At least 1 year of related work experience.
Job Responsibility
Job Responsibility
  • Meet group coordinator/host(ess) prior to functions, make introductions, and ensure that all arrangements are agreeable
  • Read and analyze banquet event order in order to gather guest information, determine proper set up, timeline, specific guest needs, buffets, action stations, etc.
  • Respond to and try to fulfill any special banquet event arrangements
  • Follow up on special banquet event arrangements to ensure compliance
  • Follow all company and safety and security policies and procedures
  • report accidents, injuries, and unsafe work conditions to manager
  • and complete safety training and certifications
  • Ensure uniform and personal appearance are clean and professional, maintain confidentiality of proprietary information, and protect company assets
  • Welcome and acknowledge all guests according to company standards, anticipate and address guests’ service needs, and thank guests with genuine appreciation
  • Speak with others using clear and professional language, and answer telephones using appropriate etiquette
  • Fulltime
Read More
Arrow Right
New

Pharmacy Manager

We’re building a world of health around every individual — shaping a more connec...
Location
Location
United States , Redford
Salary
Salary:
65.00 - 85.00 USD / Hour
https://www.cvshealth.com/ Logo
CVS Health
Expiration Date
July 04, 2026
Flip Icon
Requirements
Requirements
  • Active Pharmacist License in the state where the Store is located
  • Active National Provider Identifier (NPI)
  • Not on the DEA Excluded Parties list
  • 1-2 years of experience as a Pharmacist
Job Responsibility
Job Responsibility
  • Living our purpose by helping to manage and improve patient health through safe and appropriate dispensing, counseling, and immunizing practices
  • Overseeing the pharmacy team during bench shifts, including strengthening pharmacy performance measures through effective coaching and consistent follow-up of pharmacy team members
  • Supporting safe and accurate prescription fulfillment by following—and directing the pharmacy team to follow—pharmacy workflow procedures and utilizing the safety guardrails at every workstation
  • Contributing to positive patient experiences by showing empathy and genuine care, and coaching the pharmacy team to do the same: demonstrating compassionate care, collaborating with the patient’s total healthcare team, and proactively resolving insurance and/or medication issues
  • Proactively offering and delivering immunizations to keep patients healthy
  • identifying, engaging, and supporting Pharmacy Technicians to learn to immunize
  • Supporting the effective management of pharmacy inventory by following—and coaching the pharmacy team to follow—all inventory best practices, with a special focus on protecting cold chain products for our patients and our business
  • Conducting new Technician and Pharmacist onboarding for the store and district, including training on CVS workflow, and ensuring all trainees are on-track for timely completion of required training and/or licensure
  • Ensuring pharmacy operations are fully compliant with state Board of Pharmacy regulations at all times
  • escalating issues or concerns to the Rx DL for additional support if/as needed
What we offer
What we offer
  • medical
  • dental
  • vision coverage
  • paid time off
  • retirement savings options
  • wellness programs
  • Fulltime
Read More
Arrow Right
New

Administrator

At Currys we’re united by one passion: to help everyone enjoy amazing technology...
Location
Location
United Kingdom , Thetford
Salary
Salary:
27641.00 GBP / Year
currysplc.com Logo
Currys plc
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Some experience or exposure to providing customer service
  • Passion and enthusiasm for working in a fast-paced team
  • Experience with Excel and Word
Job Responsibility
Job Responsibility
  • Communicating with our internal and external customers
  • Assigning delivery drivers with their routes
  • Completing administrative tasks including producing data for reporting
  • Supporting the whole of the Currys team with queries or support where required
  • Fulltime
Read More
Arrow Right