Managers of DRG Coding & Clinical Validation Audit
Elevance Health(1 month ago)
About this role
The Manager of DRG Coding & Clinical Validation leads a team that audits inpatient medical records to ensure accurate and compliant Diagnosis-Related Group (DRG) assignments. The role focuses on identifying coding discrepancies, recoverable claim opportunities, and supporting regulatory and payer-specific integrity for the company and its clients. This position is part of Carelon Payment Integrity within Elevance Health and partners cross-functionally to align audit insights with broader program goals.
Required Skills
- DRG Coding
- Clinical Validation
- Audit Methodologies
- Project Management
- Team Leadership
- ICD-10
- Data Analytics
- Process Improvement
- Performance Reporting
- Provider Engagement
+2 more
Qualifications
- BA/BS
About Elevance Health
elevancehealth.comElevance Health, formerly Anthem, Inc., serves people across their entire health journey taking an integrated whole-health approach.
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