job description
Join R1 RCM, a global leader in healthcare revenue cycle management, as a DRG Validation Auditor and work remotely from the stunning locations of Bali (Canggu, Ubud, Denpasar, Jimbaran, Nusa Dua, Kuta, or Badung).
In this critical role, you will ensure coding accuracy, optimize revenue integrity, and enhance patient care by validating Diagnosis-Related Group (DRG) assignments. Your expertise will directly impact financial performance and compliance for healthcare providers across the U.S.
Enjoy a competitive salary, HMO coverage from day one, and the flexibility to work from paradise while contributing to a mission-driven organization. Whether you're a seasoned auditor or a detail-oriented professional looking to transition into healthcare revenue cycle management, this is your chance to grow with an industry leader.
Why Apply?
- Work remotely from Bali’s most vibrant locations
- Stable U.S.-based healthcare industry exposure
- Comprehensive health benefits from your first day
- Career advancement in a Fortune 500 company
- Collaborative, results-driven work culture
Responsibility
- Review and validate DRG assignments to ensure accuracy and compliance with CMS guidelines and payer-specific requirements.
- Analyze medical records, coding, and documentation to identify discrepancies, underpayments, or overpayments.
- Collaborate with coding teams, clinical staff, and revenue cycle specialists to resolve DRG-related issues.
- Conduct audits on high-volume or high-dollar cases to mitigate financial risk and improve revenue capture.
- Develop and implement process improvements to enhance coding accuracy and DRG assignment efficiency.
- Prepare detailed audit reports and recommendations for clients and internal stakeholders.
- Stay updated on evolving healthcare regulations, coding standards (ICD-10, CPT), and DRG methodologies.
- Provide training and guidance to junior auditors and coding staff on DRG validation best practices.
Qualifications
- Bachelor’s degree in Health Information Management (HIM), Nursing, or related field; or equivalent experience.
- Minimum 2+ years of experience in DRG validation, medical coding (CPC, CCS, RHIA, RHIT), or revenue cycle auditing.
- Proficiency in ICD-10-CM/PCS, CPT, and HCPCS coding systems.
- Strong understanding of MS-DRG, APR-DRG, and other grouper methodologies.
- Experience with Epic, Cerner, or other EHR systems is a plus.
- Excellent analytical, problem-solving, and communication skills.
- Ability to work independently in a remote setting with a stable internet connection.
- Certifications such as CCS, CPC, RHIA, or CDIP are highly preferred.