DRG / IRF Auditor

EXL

IRF Auditor conducting payment integrity audits for healthcare clients. Ensuring compliance and reimbursement accuracy through various documentation reviews.

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 expertise in conducting IRF payment integrity audits, validating documentation, and identifying discrepancies in coding and reimbursement. Proficient in ICD-10-CM/PCS and experienced in inpatient facility claim review and payer reimbursement methodologies.

Highest-signal resume keywords

IRF Payment Integrity AuditsICD-10-CM/PCS ProficiencyInpatient Facility Coding ExperienceCCS, RHIA, RHIT, CIC, CPC CredentialsAudit Workflow Tools Experience

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Inpatient Facility CodingPayment Integrity AuditingReimbursement ReviewMedical Record AbstractionDocumentation Validation

Soft Skills

Clear CommunicationAttention to Detail

Tools & Technologies

ExcelWordOneNoteAudit Workflow ToolsEncoder/Reference Tools

Certifications & Qualifications

CCSRHIARHITCICCPC

Industry Keywords

IRF-PAIPayer Reimbursement MethodologiesClaim ReviewContracting Requirements

About the role

Key responsibilities & impact

Conduct comprehensive IRF payment integrity audits using various documents.
Validate IRF-PAI completion and supporting documentation.
Identify documentation, coding, and reimbursement discrepancies.
Review client payment methodology and contracting requirements.
Craft clear, concise audit findings with rationale and financial impact.

Requirements

What you’ll need

Minimum High School Diploma required; higher education preferred.
CCS, RHIA, RHIT, CIC, or CPC credential preferred; multiple credentials strongly preferred.
4+ years of inpatient facility coding, auditing, payment integrity, or reimbursement review experience.
Strong understanding of ICD-10-CM/PCS, inpatient facility claim review, medical record abstraction, and payer reimbursement methodologies.
Proficient in Excel, Word, OneNote, and general computer literacy; experience with audit workflow tools and encoder/reference tools preferred.

Benefits

Comp & perks

Health insurance
Dental insurance
Vision insurance
401(k) options
Flexible work arrangements
Mentorship and career development programs
Paid time off