DRG Manager

📋 Description

• Lead the development, enhancement, and review of clinical payment solutions, including MS-DRG
• Oversee the end-to-end clinical claims review process, accounting for different client
• Collaborate with programmers, auditors, operations, product leaders, data analysts, and technology
• Monitor regulatory changes and evaluate the effectiveness of written rules, making updates when
• Lead and develop the DRG team by providing guidance, coaching, performance feedback, and
• Assign and prioritize team workloads, establish goals, coordinate daily activities, and ensure

🎯 Requirements

• Bachelor's degree in health administration, business, nursing, or a related field, or equivalent
• 5+ years of experience in healthcare billing and coding, with at least 3 years of experience in
• Demonstrated expertise in DRG validation, particularly APR-DRG and MS-DRG methodologies.
• Strong knowledge of classification and payment systems, including MS-DRG, APR-DRG, AP-DRG, APCs
• Deep understanding of Medicare and commercial coding rules, reimbursement regulations, and
• Strong knowledge of healthcare coding, billing, reimbursement, clinical criteria, and documentation

🎁 Benefits

• $125,000–$140,000 USD base salary range, plus an annual bonus.
• Meaningful equity as part of the overall compensation package.
• Fully remote work from anywhere in the United States.
• Medical, dental, and vision insurance options.
• Flexible Spending Account (FSA) and Health Savings Account (HSA) options.
• 401(k) retirement plan with company match.