Are you an experienced Inpatient DRG Auditor who thrives on complex clinical validation and payer logic?
LexiCode is expanding our elite remote audit team supporting national healthcare clients with high-level MS-DRG and APR-DRG validation services. This is a true audit role — not production coding — designed for experts who enjoy analytical review, documentation defense, and detailed rebuttal writing. As a DRG Auditor at LexiCode, you will join a dynamic team of consulting experts dedicated to delivering exceptional audit services to our valued clients.
Pay Disclosure:
LexiCode is required by state specific laws to include the salary range for this role when hiring a resident in applicable locations. The pay range for this position starts at $80,000 per year; however, base pay offered may vary depending on job-related knowledge, skills, and experience. Bonus opportunities may be provided as part of the compensation package, in addition to a full range
Essential Functions and Responsibilities
Performs analysis of medical records and provider claims to validate appropriate DRG and ICD-10-CM/PCS code assignment, including complex medical and surgical cases
Ensures that assigned codes and DRGs are supported by clinical documentation utilizing payer-specific clinical criteria
Applies Official Guidelines for Coding and Reporting consistently and appropriately
Provides detailed written explanations to support or rebut coding/DRG recommendations
Qualifications
Required:
• RHIA, RHIT, or CCS credential from AHIMA or CPC combined with RHIA, RHIT or CCS
• 3 or more years of Inpatient/DRG auditing experience in an acute care setting or payer setting
• Expertise in ICD-10-CM/PCS, IPPS/MS-DRG and APR-DRG methodology and logic
• Excellent knowledge of ICD-10-CM/PCS Official Guidelines for Coding and Reporting, AHA Coding Clinics to support audit findings
• Proficiency in identifying clinical indicators to support documented diagnoses
• Outstanding computer skills and ability to work in multiple client-specific healthcare systems
• Excellent written communication and critical thinking skills
• Ability to efficiently review large volumes of documents with high comprehension level
• Secure home office environment, compliant with HIPAA and LexiCode’s security requirements
Preferred:
• Experience in a payer coding/clinical DRG audit setting
Prior experience/roles which may qualify:
• Inpatient Coding Auditor
• Inpatient Audit Specialist
• Inpatient Coding Quality Auditor
• IP Coding Compliance Auditor
• Inpatient Coding Consultant
• Facility Coding Auditor (Inpatient)
• Inpatient DRG Validation Auditor
• DRG Revenue Integrity Auditor
• MS-DRG Auditor
• DRG Review Specialist
• DRG Compliance Auditor
• Clinical DRG Auditor
• DRG Audit Consultant
• Payer DRG Auditor
• DRG Reimbursement Auditor
#1priority
Pay: From $80,000.00 per year
Benefits:
• 401(k)
• Dental insurance
• Employee assistance program
• Employee discount
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Referral program
• Vision insurance
Experience:
• Inpatient/DRG auditing experience in acute care or payer: 3 years (Required)
• ICD-10-CM/PCS, IPPS/MS-DRG: 3 years (Required)
• APR-DRG methodology and logic: 3 years (Required)
• ICD-10-CM/PCS Official Guidelines for Coding and Reporting: 3 years (Required)
• AHA Coding Clinics to support audit findings: 3 years (Required)
License/Certification:
• RHIA, RHIT, or CCS credential from AHIMA (Required)
Work Location: Remote