Diagnosis-Related Group Manager

EXL

Lead planning and execution of DRG audit activities managing a team of auditors. Ensure compliance with coding guidelines and DRG reimbursement methodologies while supporting client needs.

Posted 5/28/2026full-timeRemote • 🇺🇸 United StatesMid-LevelSenior💰 $100,000 - $120,000 per yearWebsite

About the role

Key responsibilities & impact

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

What you’ll need

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

Comp & perks

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

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools

MS-DRGAPR-DRGICD-10-CMICD-10-PCSDRG reimbursement methodologiesauditpayment integrity operationsanalytical skills

Soft Skills

leadershipsupervisory skillseffective communicationinterpersonal skillsdecision-making

Certifications

CCSRHITRHIA