Diagnosis Related Group (DRG) Readmission Auditor

EXL

DRG Readmission Auditor conducting comprehensive reviews for accuracy in DRG assignment and reimbursement. Expertise in coding guidelines and tools essential for the role.

Posted 7/30/2026full-timeRemote • 🇺🇸 United StatesMid-LevelSenior💰 $70,000 - $110,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expert-level knowledge in MS-DRG and APR-DRG coding, with a strong focus on accuracy in DRG assignment and reimbursement. Proficient in utilizing advanced DRG encoder tools and maintaining compliance with coding guidelines and regulations.

Highest-signal resume keywords

MS-DRG Coding ExperienceAPR-DRG Coding ExperienceDRG Encoder Tools ProficiencyCCS CertificationICD-10-CM/PCS Knowledge

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

MS-DRG CodingAPR-DRG CodingICD-10-CM CodingICD-10-PCS CodingOverpayment Identification AuditingAudit Findings DocumentationData AnalysisTime ManagementProblem-SolvingComputer Literacy

Soft Skills

Written CommunicationVerbal CommunicationAttention to DetailTeamworkCollaboration

Tools & Technologies

3M EncoderWebstrat EncoderExcelWordOneNote

Certifications & Qualifications

CCSRHIARHIT

Industry Keywords

DRG AssignmentReimbursementCoding GuidelinesCompliance RegulationsQuality Standards

About the role

Key responsibilities & impact

Conduct comprehensive MS-DRG and APR-DRG readmission reviews to ensure accuracy in DRG assignment and reimbursement.
Apply expert knowledge of coding guidelines and utilize industry-leading tools to maximize overpayment identifications.
Craft clear, concise, and well-supported audit findings.
Utilize advanced DRG encoder tools (such as 3M, Webstrat) to drive efficiency and accuracy in audits.
Meet or exceed EXL’s quality and productivity standards.
Stay ahead of industry trends, coding updates, and compliance regulations.

Requirements

What you’ll need

Minimum High School Diploma (Higher education preferred).
CCS, RHIA, or RHIT credential (Multiple credentials preferred).
4+ years of MS-DRG/APR-DRG coding experience.
Prior experience in DRG readmission retrospective overpayment identification auditing is highly desirable.
Strong proficiency with DRG encoder tools (3M, Webstrat).
Expert-level inpatient coding knowledge with an in-depth understanding of ICD-10-CM/PCS coding guidelines.
Exceptional time management, problem-solving, and analytical skills.
Strong written and verbal communication with attention to detail.
Proficient in Excel, Word, and OneNote, with strong overall computer literacy.
Passion for DRG readmission auditing and a commitment to teamwork, collaboration, and continuous learning.

Benefits

Comp & perks

A fast-paced, innovative environment with a team of industry-leading experts.
Hands-on experience with top-tier clients in the healthcare industry.
Mentorship and career development programs.
A strong culture of collaboration, support, and inclusivity.
Competitive benefits package, including healthcare, vision, dental, and 401(k) options.