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Keywords: Manager, Clinical & Coding Review (DRG), Location: USA

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Manager, Clinical & Coding Review (DRG)

, CPT/HCPCS coding, and clinical guidelines, the manager delivers actionable insights that shape operational strategies...+ years DRG review experience, Clinical Documentation Improvement experience required Proficiency ICD-10-CM/PCS, MS-DRG, APR...

Company: Centene
Location: USA
Posted Date: 19 Feb 2026
Salary: $107700 - 199300 per year

Managers of DRG Coding & Clinical Validation Audit

Anticipated End Date: 2026-03-16 Position Title: Managers of DRG Coding & Clinical Validation Audit... Job Description: Manager of DRG Coding Audit-Program/Project Locations: The selected candidate must reside within a reasonable commuting...

Company: Elevance Health
Location: Indianapolis, IN
Posted Date: 14 Feb 2026
Salary: $111040 - 199872 per year

DRG Coding Auditor Principal

, for all lines of business, and its clients. Specializes in review of DRG coding via medical record and attending physician...Anticipated End Date: 2026-02-13 Position Title: DRG Coding Auditor Principal Job Description: DRG Coding Auditor...

Company: Elevance Health
Location: Chicago, IL
Posted Date: 04 Feb 2026

Coding Auditor - DRG/APC Coordinator

reimbursement Provides DRG/APC and coding quality information and statistical reports to the Coding Manager Communicates... optimizing function to review data for accuracy Reviews PRO coding changes, reports findings to the Coding Manager...

Posted Date: 23 Jan 2026

Coding Auditor - DRG/APC Coordinator

reimbursement Provides DRG/APC and coding quality information and statistical reports to the Coding Manager Communicates... optimizing function to review data for accuracy Reviews PRO coding changes, reports findings to the Coding Manager...

Posted Date: 23 Jan 2026

Diagnosis Related Group Clinical Validation Auditor-RN (CDI, MS-DRG, AP-DRG and APR-DRG)

(CPC) or Inpatient Coding Credential such as CCS or CIC. Experience with third party DRG Coding and/or Clinical...Anticipated End Date: 2026-03-09 Position Title: Diagnosis Related Group Clinical Validation Auditor-RN (CDI, MS-DRG...

Company: Elevance Health
Location: Mason, OH
Posted Date: 07 Feb 2026
Salary: $81852 - 155088 per year

Diagnosis Related Group Clinical Validation Auditor-RN (CDI, MS-DRG, AP-DRG and APR-DRG)

(CPC) or Inpatient Coding Credential such as CCS or CIC. Experience with third party DRG Coding and/or Clinical...Anticipated End Date: 2026-02-13 Position Title: Diagnosis Related Group Clinical Validation Auditor-RN (CDI, MS-DRG...

Company: Elevance Health
Location: Costa Mesa, CA
Posted Date: 29 Jan 2026
Salary: $81852 - 155088 per year

Clinical Appeals-DRG Auditor

from an accredited institution. •5+ years of inpatient/acute hospital coding, DRG auditing, or medical record review experience...Purpose The DRG Auditor – Clinical Appeals is responsible for conducting comprehensive retrospective reviews...

Location: California
Posted Date: 03 Dec 2025

Acute Coding Quality Review Auditor

. Job Summary: Performs quality reviews and audits to ensure compliance with DRG validation, ICD-10/PCS, and CPT coding guidelines... expert level knowledge of medical coding practices and concepts. Communicates appropriately with manager and all stakeholders...

Company: Adventist Health
Location: Roseville, CA
Posted Date: 20 Dec 2025

Acute Coding Quality Review Auditor

. Job Summary: Performs quality reviews and audits to ensure compliance with DRG validation, ICD-10/PCS, and CPT coding guidelines... expert level knowledge of medical coding practices and concepts. Communicates appropriately with manager and all stakeholders...

Company: Adventist Health
Location: Roseville, CA
Posted Date: 06 Dec 2025

Senior Manager, Clinical and Coding

Job Title: Senior Manager, Clinical & Coding Location: Remote Employment Type: Full‑Time Position Summary Health... Business Solutions (HBiz) is seeking an experienced and strategic Senior Manager, Clinical & Coding to lead and oversee...

Posted Date: 13 Feb 2026

Inpatient DRG Validator (Acute Care)

records and other documentation to evaluate issues of coding and DRG assignment accuracy. Specializes in review of DRG coding... and Experiences: BA/BS preferred. Experience with vendor based Diagnosis-Related Group (DRG) Coding/Clinical Validation Audit...

Company: Elevance Health
Location: Indianapolis, IN
Posted Date: 19 Feb 2026
Salary: $95172 - 149556 per year

Auditor Technical Trainer - DRG

, Readmissions, Outpatient and Specialty Review Types. Train Clinicians with coding certifications on DRG coding principles. Confer... members on concepts as needed. Provide training on DRG & Clinical Validation, Short Stay, to include Milliman, InterQual...

Company: Cotiviti
Location: USA
Posted Date: 11 Feb 2026
Salary: $105000 - 125000 per year

DRG Appeals Nurse

Purpose: The Clinical Appeals Review Nurse reviews and analyzes denied/downgraded MS-DRG and APR-DRG and APC accounts... received from all types of payers (e.g., Medicare, Commercial, and Third Party). Utilizing clinical and coding expertise, the...

Location: California
Posted Date: 05 Feb 2026

HIM Coding - Clinical Documentation Educator

under the supervision of the Health Information Manager. The primary job function of the Health Information Management Coding... and Clinical Documentation Educator is to oversee the HIM coding compliance program, to include coding, auditing and query...

Posted Date: 21 Jan 2026

Lead Clinical Review Nurse

Anticipated End Date: 2026-03-27 Position Title: Lead Clinical Review Nurse Job Description: Location: This role... and skill development. The Lead Clinical Review Nurse is responsible for serving as a team lead for nursing staff who...

Company: Elevance Health
Location: Mason, OH
Posted Date: 14 Feb 2026

Coding Manager (Medical)- Santa Ana, CA Direct Hire

Job Title: Coding Manager Department: CBO Reports to: Completion Date: SUMMARY The Coding Manager has overall.... Evaluates the effectiveness of coding personnel and processes. Performs review, monitors, and makes effective change...

Location: Santa Ana, CA
Posted Date: 12 Feb 2026

Medical Coding Audit Manager - Remote

Description : About IKS Health IKS Health takes on the chores of healthcare, reducing administrative, clinical... supports large health systems across the United States. For more information, visit: www.ikshealth.com Audit Manager...

Company: Aquity
Location: USA
Posted Date: 18 Jan 2026
Salary: $90000 - 100000 per year

HB Outpatient Coding System Manager - Remote

performance by serving in a manager capacity for Coding and Coding Compliance functions. The Manager of System Coding is a Coding... Professional with a high level of clinical proficiency necessary for the oversight of the coding department and is responsible...

Company: LCMC Health
Location: New Orleans, LA
Posted Date: 14 Jan 2026

Case Manager LVN Utilization Review FT MMC

clinical associate will perform retrospective reviews for payors, utilizing the current documentation system and enter the... appropriate ICD/CPT and DRG when indicated. May be occasions when it will be necessary to work weekends, holidays, evenings...

Location: McAllen, TX
Posted Date: 19 Dec 2025