CrawlJobs Logo

DRG Validation Coding Auditor

https://www.roberthalf.com Logo

Robert Half

Location Icon

Location:
United States , Cincinnati

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
  • 401(k) plan

Additional Information:

Job Posted:
March 01, 2026

Job Link Share:

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

Briefcase Icon

Similar Jobs for DRG Validation Coding Auditor

Inpatient DRG Nursing Auditor

Join our team in Manila as Inpatient DRG Nursing Auditor. If you’re a registered...
Location
Location
Philippines , Taguig City
Salary
Salary:
Not provided
accesshealthcare.com Logo
Access Healthcare LLC
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Good Comprehension skills
  • Strong attention to detail and communication skills
  • Curious and willing to ask relevant questions
  • Ability to understand client guidelines related to insurance advantage claims
  • Must be Philippine Registered Nurse with Active license
  • Must have an experience in clinical and audit in IP DRG
Job Responsibility
Job Responsibility
  • Conduct initial audit reviews to validate billed diagnoses and DRG code are supported by medical records
  • Record audit results and document finding notes based on policies using professional clinical resources
  • Perform provider appeals reviews and render decision to either uphold or overturn original finding
  • Review questionable encoder results, complex cases, and appeal reviews to facilitate referrals to clinical department as needed
  • Propose new audit concepts supported by your research and analysis
  • Define new audit concept criteria and test and validate new concepts developed by analytics team
  • Escalate facility issues per client guidance
Read More
Arrow Right
New

Logistics Manager

We are seeking a highly experienced and motivated Logistics Manager to work on a...
Location
Location
United Kingdom , Isle of Skye
Salary
Salary:
Not provided
https://www.randstad.com Logo
Randstad
Expiration Date
March 21, 2026
Flip Icon
Requirements
Requirements
  • Bachelor's degree in logistics, supply chain management, or a related field
  • Proven experience in logistics management, preferably in the pipeline or civil engineering sector
  • In-depth knowledge of logistics principles, best practices, and regulations
  • Strong leadership and team management skills, with the ability to motivate and develop a diverse team
  • Excellent organisational and problem-solving abilities, with a keen attention to detail
  • Effective communication and interpersonal skills, with the ability to collaborate with multidisciplinary teams and stakeholders
  • Proficiency in logistics software and systems for inventory management and transportation tracking
  • Familiarity with health, safety, and environmental regulations in the pipeline industry
  • Ability to work under pressure and meet tight deadlines
Job Responsibility
Job Responsibility
  • Develop and implement logistics strategies and plans for the pipeline project, ensuring efficient and cost-effective operations
  • Coordinate with project managers, suppliers, and contractors to ensure timely delivery of equipment, materials, and personnel to the project site
  • Manage the logistics team, including hiring, training, and performance evaluation
  • Monitor and track inventory levels, ensuring an adequate supply of materials and equipment at all times
  • Oversee transportation activities, including coordinating with shipping companies, arranging permits, and ensuring compliance with relevant regulations
  • Implement effective safety and security protocols to protect personnel and assets during transportation and storage
  • Evaluate and select suppliers and contractors, negotiating contracts and managing vendor relationships
  • Develop and maintain strong relationships with internal and external stakeholders, including project team members, clients, and government authorities
  • Monitor project timelines and budgets, identifying and resolving logistics-related issues that may impact project delivery
  • Conduct regular reporting and analysis of logistics operations, providing recommendations for process improvement and cost reduction
Read More
Arrow Right
New

Bid Manager

Our large Utilities client is currently hiring for a Bid Manager position. You w...
Location
Location
Ireland , Castlebar
Salary
Salary:
Not provided
https://www.randstad.com Logo
Randstad
Expiration Date
March 05, 2026
Flip Icon
Requirements
Requirements
  • 7-8 years of experience in a similar role
  • Experience managing multiple internal and external stakeholders
  • Understand the procurement processes
Job Responsibility
Job Responsibility
  • Responsible for the production, quality and timely delivery of compliant, commercially sound, market-leading, winning bids and proposals
  • Manage the Client/Supplier experience and relationship
  • Plan and manage bid teams and inputs from a variety of internal stakeholders
!
Read More
Arrow Right
New

Property Manager

Location
Location
United Kingdom , St Neots
Salary
Salary:
Not provided
https://www.randstad.com Logo
Randstad
Expiration Date
March 27, 2026
Flip Icon
Requirements
Requirements
  • Good understanding of Residential Property Management and current legislation
  • Well developed interpersonal and oral communications skills
  • Interpersonal skills and customer focused
  • Ability to work on own initiative
  • Good literate and numerical skills
  • Diplomacy
  • Ability to prioritise workload and work under pressure
  • Candidates must be eligible to live and work in the UK
Job Responsibility
Job Responsibility
  • Manage portfolio in accordance with RICS Codes of Practice, ARMA rules
  • Assisting the Senior Property Manager to provide a full professional property management services for a portfolio of freehold/leasehold developments and individual properties on behalf of freehold clients, Developers and Resident Management Companies, proactively manage in relation to managing agent/SLA
  • Assisting the Senior Property Manager to manage in relation to company targets of income and service delivery
  • Dealing with leaseholders enquiries appertaining to the development
  • Handling telephone calls and taking detailed messages/dealing with them in an appropriate manner
  • Responding to correspondence/emails including those from Directors, lessees and tenants - as requested by the Senior Property Manager or Team Leader
  • Issue Draft Minutes to Directors
  • Action Minutes
  • Write to lessees/tenants/letting agents in relation to any matters which may contravene the terms of the lease, i.e. noise/nuisance, satellite dishes, untaxed vehicles, pets, etc
  • Contacting the DVLA regarding abandoned cars following procedures
Read More
Arrow Right
New

High-bay operator

We are looking for an additional, motivated colleague for the challenging role o...
Location
Location
Belgium , Ypres
Salary
Salary:
Not provided
https://www.randstad.com Logo
Randstad
Expiration Date
March 26, 2026
Flip Icon
Requirements
Requirements
  • Working at Heights: You will operate our high-bay installation, which includes occasionally climbing up to 30 meters for inspections or technical interventions
  • Physical Stamina: You are in good physical condition to handle various job-related tasks (such as using equipment to maneuver pallets into the correct positions)
  • Technical Insight: You have the ability to detect, troubleshoot, and resolve mechanical or system malfunctions
  • Process Management: You possess solid computer skills and a strong understanding of industrial processes and systems
  • Shift System: You will work in a rotating 2-shift system: 06:00 AM – 02:00 PM and 02:00 PM – 10:00 PM
Job Responsibility
Job Responsibility
  • Process Execution: Carrying out all designated process orders and tasks accurately
  • Flow Monitoring: Monitoring the product flow across the entire system to ensure seamless operations
  • Inbound & Outbound Recovery: Performing corrective actions and interventions during the inbound (storage) or outbound (retrieval) processes
  • Labeling & Verification: Checking and applying labels to ensure full traceability of goods
  • Administrative Support: Handling limited administrative tasks and email correspondence in support of your core duties
  • Loading & Unloading: Safely loading and unloading trucks using the appropriate equipment
  • General Maintenance: Performing non-technical maintenance tasks to keep the installation in top condition
  • Food Safety & Compliance: Operating in accordance with monitoring procedures for Critical Control Points (CCPs) during the storage and transport of food products, and reporting any deviations to your supervisor immediately
  • Fulltime
Read More
Arrow Right
New

Butcher

Are you a skilled craftsman with a passion for meat? For a renowned food company...
Location
Location
Belgium , Staden
Salary
Salary:
Not provided
https://www.randstad.com Logo
Randstad
Expiration Date
March 30, 2026
Flip Icon
Requirements
Requirements
  • Experience: You have initial experience as a butcher, meat cutter, or deboner. You are familiar with the basic techniques of the trade.
  • Languages: You speak and understand English, Dutch, OR French.
  • Flexibility: Waking up early is no problem for you. You are willing to work on Saturdays (on a rotating schedule) and are comfortable with flexible end times.
  • Attitude: You work accurately, maintain high hygiene standards, and feel a strong sense of responsibility toward the product.
Job Responsibility
Job Responsibility
  • Professionally cutting, deboning, and trimming various types of meat.
  • Strictly following hygiene and safety regulations (HACCP).
  • Monitoring the quality of the meat during different stages of the process.
  • Ensuring a clean and organized workspace together with your colleagues.
  • Fulltime
Read More
Arrow Right
New

Calibration engineer

Are you a specialist in metrology and do you have an eye for detail? For our cli...
Location
Location
Netherlands , Eindhoven
Salary
Salary:
4200.00 EUR / Month
https://www.randstad.com Logo
Randstad
Expiration Date
March 06, 2026
Flip Icon
Requirements
Requirements
  • An MBO+/HBO (vocational/bachelor) working and thinking level in Automotive Engineering, Mechatronics, Electrical Engineering, or similar
  • Experience with measurement and control technology, and preferably with calibration processes in a test environment
  • Familiarity with methodologies such as MSA (Measurement System Analysis) and PDCA (Plan-Do-Check-Act) is a strong plus
  • Experience with planning and organizing (setting up and adjusting calibration schedules)
Job Responsibility
Job Responsibility
  • Executing calibrations: You handle the semi-annual calibration of fixed test cell equipment (excluding emission equipment) according to the schedule in Tracks
  • Reporting: After every calibration, you draft detailed calibration reports using the tools provided by DAF
  • Troubleshooting & Maintenance: In the event of incidents, you perform interim calibrations and resolve small equipment faults on-site
  • Optimization: You actively work on improving calibration protocols within the test stand control system
  • Commissioning: You are involved in the debugging and commissioning of new or modified calibration equipment
  • Quality Assurance: You provide input for improvement processes such as PDCAs (Plan-Do-Check-Act) and MSAs (Measurement System Analysis)
  • Expert Role: You act as the primary point of contact (the "go-to person") for colleagues regarding questions about calibration, metrology, and the test stands
  • Fulltime
!
Read More
Arrow Right
New

Computational modeling engineer

As a Computational Modeling Engineer, you will be a key player within the Innova...
Location
Location
Netherlands , Eindhoven
Salary
Salary:
Not provided
https://www.randstad.com Logo
Randstad
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Preferably a PhD in Applied Physics, (Bio)Medical Engineering, Mechanical Engineering, or a closely related scientific field
  • A solid foundation in physics-based and mechanistic modeling (e.g., solid mechanics, fluid dynamics, multiphysics, or transport phenomena)
  • Hands-on experience with simulation tools such as COMSOL Multiphysics, ANSYS, Abaqus, Star-CCM+, or OpenFOAM
  • Proven ability to translate complex simulation data into clear, strategic insights for R&D stakeholders and engineering teams
  • A track record of applying theoretical modeling to real-world engineering challenges
Job Responsibility
Job Responsibility
  • Use advanced "Digital Twins" and simulations to solve complex medical challenges
  • Provide deep physical insights to de-risk innovation and accelerate the development of life-changing medical devices
  • Translate high-level physics into actionable design decisions that impact the entire health continuum
Read More
Arrow Right