DRG Reviewer at Centene

This role is designed for an experienced medical coding professional with a deep mastery of inpatient reimbursement systems. The ideal candidate has at least four years of hands-on MS-DRG/APR-DRG coding experience and a strong background in payment integrity or payer-side auditing. You must hold a relevant credential such as a CCS, RHIT, or RHIA and be comfortable making independent, authoritative decisions on complex clinical documentation. The most attractive aspect of this position is the fully remote work arrangement coupled with a broad salary range that reaches up to $126k. As part of a massive national healthcare organization, you will receive a comprehensive benefits package that includes a stock purchase plan and tuition reimbursement. The role offers significant autonomy, allowing you to influence medical policy and audit methodologies rather than just performing routine data entry. **You might be a good fit if you...** * Have 4+ years of expert-level experience in ICD-10-CM/PCS and DRG validation. * Are proficient with industry-standard encoders like 3M, Optum, or TruCode. * Hold an active CCS, RHIA, RHIT, or CCDS certification. * Excel at navigating complex clinical records to identify upcoding or errors without direct supervision.