DRG Nursing Auditor – Devoted Health – Florida

A bit about us:

We’re on a mission to change healthcare — how it’s paid for, delivered, experienced. We want to put people center stage, not process or profit. We are guided by a deep belief that every person on Medicare should be treated like we would treat a member of our own family: with loving care and a profound commitment to their health and well-being.

Why Devoted:

Make a difference… a big difference. You will have the opportunity, in a unique and dynamic culture, to be a part of something incredibly meaningful. We’re a disruptive startup with an inspiring mission. Learn and grow alongside our world-class team of healthcare, technology, and data leaders, dedicated to building a health plan and clinical services that care for everyone like they were our own mothers or fathers. Our team and board members have decades of experience in health care entrepreneurship, data, technology, services, and policy. With their support, we look forward to building a health plan and clinical services that will give seniors easy access to the high-quality care they deserve.

A bit more about this role:

At Devoted, we know that one of the most important ways we will build trust is by ensuring we pay claims accurately and on time. We also have a fiduciary responsibility to protect the Medicare Fund and this role will play an integral part in doing that. The DRG/CVA/HBA auditor performs DRG reviews by validating accuracy of the DRG code assignment completeness, POA, discharge status, etc. to ensure accurate payment to our providers. The DRG/CVA/HBA auditor determines if a discrepancy exists in the coding and clinical documentation using standard documentation guidelines applicable to the program. This Remote position will primarily perform DESK audits, validate vendor identification, and perform dispute reviews. The role will also perform a limited number of ONSITE audits in the Florida market. Onsite audits may require minimal travel to the providers location on an agreed upon schedule to perform the audit review.

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If you love running towards complex challenges and transforming them into solutions, if you want to make a potentially huge impact on many lives, and if you are looking for a disruptive startup with an inspiring and talented team, Devoted Health may be the place for you! If you lack a specific credential for this position but believe that your strengths and life experiences will propel our mission, we would love to hear from you.

Devoted is an equal opportunity employer. We are committed to a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the business. We value diversity and collaboration. Individuals are respected for their skills, experience, and unique perspectives. This commitment is embodied in Devoted’s Code of Conduct, our company values and the way we do business.

As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.

COVID-19 Vaccination Requirement: Where permitted by applicable law, candidates must have received or be willing to receive the COVID-19 vaccine by date of hire to be considered. The Company will provide reasonable accommodations to qualified employees with disabilities or for a sincerely held religious belief, practice, or observance.