DRG Clinical (RN) Validation Auditor

The DRG Clinical (RN) Validation Auditor at Elevance Health reviews inpatient medical records to ensure clinical documentation substantiates billed Diagnosis Related Groups (DRGs) and reimbursements. The role focuses on validation of DRG paid claims and operates primarily in a virtual capacity with required in-person training. It supports the organization’s coding, compliance, and documentation integrity efforts within the clinical operations function.