Diagnosis-Related Group Auditor III

EXL

. Conduct comprehensive MS-DRG and APR-DRG coding reviews to ensure accuracy in DRG assignment and reimbursement .

Posted 11/2/2026full-timeRemote • Florida • United StatesMid-LevelSenior💰 $73,000 - $98,700 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in MS-DRG and APR-DRG coding, ensuring accuracy in DRG assignment and reimbursement while adhering to AHA Coding Guidelines and ICD-10-CM/PCS regulations. Proficient in using advanced DRG encoder tools and committed to maintaining compliance with HIPAA and industry standards.

Highest-signal resume keywords

MS-DRG Coding ExperienceAPR-DRG Coding ExperienceAHA Coding Guidelines ExpertiseDRG Encoder Tools ProficiencyICD-10-CM/PCS Knowledge

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

MS-DRG CodingAPR-DRG CodingAHA Coding GuidelinesICD-10-CM CodingICD-10-PCS CodingDRG Reimbursement MethodologiesOverpayment Identification AuditingExcel ProficiencyWord ProficiencyOneNote Proficiency

Soft Skills

Time ManagementProblem-SolvingAnalytical SkillsWritten CommunicationVerbal CommunicationAttention to DetailTeamworkCollaborationContinuous Learning

Tools & Technologies

3M EncoderWebstrat Encoder

Certifications & Qualifications

CCSCICCPCRHIARHIT

Industry Keywords

HIPAA ComplianceEXL PoliciesCoding AuditingData SecurityRegulatory Compliance

About the role

Key responsibilities & impact

Conduct comprehensive MS-DRG and APR-DRG coding reviews to ensure accuracy in DRG assignment and reimbursement
Apply coding guideline expertise and industry-leading tools to maximize overpayment identifications
Craft clear, concise, and well-supported audit findings backed by AHA Coding Clinic Guidelines and ICD-10-CM/PCS regulations
Use advanced DRG encoder tools such as 3M and Webstrat to improve audit efficiency and accuracy
Meet or exceed EXL quality and productivity standards, including strong uphold rates for appeals
Stay current with industry trends, coding updates, and compliance regulations
Adhere to HIPAA and EXL policies and procedures to ensure data security and regulatory compliance

Requirements

What you’ll need

Minimum High School Diploma (higher education preferred)
CCS, CIC, CPC, RHIA, or RHIT credential; multiple credentials preferred
4+ years of MS-DRG/APR-DRG coding experience
Deep understanding of AHA Coding Guidelines and DRG reimbursement methodologies
Prior experience in DRG retrospective overpayment identification auditing highly desirable
Strong proficiency with DRG encoder tools, including 3M and Webstrat
Expert-level inpatient coding knowledge
In-depth understanding of ICD-10-CM/PCS coding guidelines
Ability to work independently in a remote environment
Exceptional time management, problem-solving, and analytical skills
Strong written and verbal communication and attention to detail
Proficiency in Excel, Word, OneNote, and overall computer literacy
Commitment to teamwork, collaboration, and continuous learning
Ability to adhere to HIPAA and EXL policies and procedures
A brief coding/auditing assessment may be included in the interview process

Benefits

Comp & perks

Fully remote work experience from a home office
Up to 10% annual travel for team meetings and limited client onsite engagements
Industry-leading training
Career development opportunities
Mentorship and career development programs
Healthcare, vision, and dental benefits
401(k) options
Collaborative, supportive, and inclusive culture
Hands-on experience with top-tier healthcare clients