DRG Quality Manager
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What you'll do
- Directly manages a team of DRG quality analysts responsible for reviewing auditor-completed MS-DRG and APR-DRG work
- Validating audit accuracy
- Ensuring accurate coding and reimbursement outcomes
- Overseeing additional quality specialties within clinical or coding audit programs
What they're looking for
- Strong leadership and analytical skills
- Expertise in Coding Guidelines, Coding Clinic, and audit tools
- Solid understanding of CMS regulations, payer requirements, and quality governance
Summarised by NextRaise from the employer’s description, which follows in full below.
Full description from employer
The role directly manages a team of DRG quality analysts responsible for reviewing auditor-completed MS-DRG and APR-DRG work, validating audit accuracy, and ensuring accurate coding and reimbursement outcomes. This leader may also oversee additional quality specialties within clinical or coding audit programs. The ideal candidate demonstrates strong leadership and analytical skills, along with expertise in Coding Guidelines, Coding Clinic, audit tools, and a solid understanding of CMS regulations, payer requirements, and quality governance.
Salary Range: $100,000 – $120,000, based on experience, skills, and qualifications.
Location: 100% Remote, U.S.-based.
Travel: Limited travel may be required for team meetings.
A brief coding/auditing assessment may be included as part of the interview process.
For more information on benefits and what we offer, please visit us at https://www.exlservice.com/us-careers-and-benefits.
Company
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