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Drg Auditor Jobs (NOW HIRING)

MMC Group

DRG Auditor

San Antonio, TX · Remote

DRG Validation Auditors are charged with rendering appropriate, well-supported, and thoroughly-documented decisions, which may result in identification of improper payments (overpayments and ...

Cotiviti

Auditor Clinical Validation DRG

$45.67/hr

Inpatient DRG/APR-DRG. This position is responsible for auditing inpatient claims and documenting the results of those audits, with a focus on clinical review, coding accuracy, and the ...

Cotiviti

$45.67/hr

Inpatient DRG/APR-DRG. This position is responsible for auditing inpatient claims and documenting the results of those audits, with a focus on clinical review, coding accuracy, and the ...

Cotiviti

$45.67/hr

Inpatient DRG/APR-DRG. This position is responsible for auditing inpatient claims and documenting the results of those audits, with a focus on clinical review, coding accuracy, and the ...

Emory Healthcare

Inpatient DRG Coding Auditor

Atlanta, GA

$26 - $29.50/hr

Description We are seeking an experienced Inpatient DRG Coding Auditor to extract data from patient encounters ensuring the accuracy of DRGs. This individual will: * Reviews inpatient medical records ...

Robert Half

DRG Validation Coding Auditor

Roanoke, VA · Remote

$86K - $90K/yr

We are looking for an experienced DRG Validation Coding Auditor to support accurate, compliant inpatient coding reviews for acute care services in Roanoke, Virginia. This position focuses on ...

Emory Healthcare

Inpatient DRG Coding Auditor

Atlanta, GA

$26 - $29.50/hr

Description We are seeking an experienced Inpatient DRG Coding Auditor to extract data from patient encounters ensuring the accuracy of DRGs. This individual will: * Reviews inpatient medical records ...

Emory Healthcare

Inpatient DRG Coding Auditor

Atlanta, GA

$39.31 - $47.90/hr

We are seeking an experienced Inpatient DRG Coding Auditor to extract data from patient encounters ensuring the accuracy of DRGs. This individual will: * Reviews inpatient medical records for select ...

Emory Healthcare

Inpatient DRG Coding Auditor

Atlanta, GA · On-site

$26 - $29.50/hr

Description We are seeking an experienced Inpatient DRG Coding Auditor to extract data from patient encounters ensuring the accuracy of DRGs. This individual will: * Reviews inpatient medical records ...

R1

DRG Validation Auditor I

$48K - $81K/yr

As our DRG Validation Auditor I , your primary role will be auditing inpatient cases for DRG validation and/or documentation improvement. This consists of reviewing accounts in proprietary software ...

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How much do drg auditor jobs pay per hour?

As of Jul 27, 2026, the average hourly pay for drg auditor in the United States is $19.21, according to ZipRecruiter salary data. Most workers in this role earn between $14.42 and $19.23 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a DRG Auditor, and why are they important?

To thrive as a DRG Auditor, you need a strong understanding of medical coding, clinical documentation, and reimbursement methodologies, typically supported by a background in health information management and certifications such as CCS or RHIA. Familiarity with coding systems like ICD-10-CM/PCS, grouper software, and electronic health records (EHRs) is essential. Attention to detail, analytical thinking, and effective communication are important soft skills for ensuring coding accuracy and collaborating with healthcare providers. These skills and qualifications are crucial for ensuring compliant and accurate reimbursement, minimizing errors, and supporting the financial integrity of healthcare organizations.

What is a DRG Auditor?

A DRG Auditor is a healthcare professional who reviews medical records and coding to ensure that Diagnosis-Related Groups (DRGs) are assigned accurately for hospital billing and reimbursement. Their work helps hospitals receive correct payments from insurance providers and government programs like Medicare and Medicaid. DRG Auditors identify coding errors, educate staff, and help maintain compliance with regulations. Their expertise is crucial for minimizing financial losses and avoiding legal issues related to improper billing.

How does a DRG Auditor typically collaborate with clinical staff and coding teams to ensure accurate reimbursement?

As a DRG Auditor, collaboration with clinical staff and coding teams is essential to ensure the accuracy of Diagnosis-Related Group (DRG) assignments and compliant billing practices. Auditors regularly review medical records and coding abstracts, then communicate findings and recommendations to coders and clinicians. This partnership helps clarify documentation, resolve discrepancies, and implement best practices for clinical documentation improvement (CDI). Effective communication skills and a collaborative mindset are crucial, as these interactions directly impact institutional compliance and reimbursement outcomes.
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Drg Auditor jobs near you
Infographic showing various Drg Auditor job openings in the United States as of July 2026, with employment types broken down into 89% Full Time, 8% Part Time, 2% Contract, and 1% Nights. Highlights an 87% Physical, 6% Hybrid, and 7% Remote job distribution, with an average salary of $39,947 per year, or $19.2 per hour.
DRG Auditor

DRG Auditor

MMC Group

San Antonio, TX • Remote

Full-time

Posted 7 days ago

Job description


Job Description:

A leader in providing clinical auditing services to public and commercial healthcare payers throughout the US, has openings for remote DRG Validation Auditors. As members of the DRG Validation Team and working remotely, incumbents will be responsible for reviewing medical records to determine the accuracy of coding and reimbursement for clinical services rendered to beneficiaries of various health plans, including Commercial, Medicare, and Medicaid Clients. DRG Validation Auditors are charged with rendering appropriate, well-supported, and thoroughly-documented decisions, which may result in identification of improper payments (overpayments and underpayments) on paid claims on behalf of the client from various providers of clinical services, including but not limited to acute care, long-term acute care, acute rehabilitation, and skilled nursing facilities, as well as other provider types and care settings. Initially, DRG Validation Auditors are prepared for the role through a detailed, well-defined training process, gaining knowledge and skills in methods for review of medical records and other provider documentation. Ongoing training and education are provided specific to audit processes, coding and reimbursement changes, and other topics as well. The DRG Validation Auditor reports to a DRG Validation Team Leader, who provides support, feedback, and guidance to DRG Validation Auditors. Moreover, quality assurance is provided through a well-defined review and quality management program performed by the Professional Development Team.


Specifically, DRG Validation Auditors will be responsible for the following:


  • Review inpatient medical records to validate the admit order, assignment and sequencing of ICD9-CM diagnosis and procedure codes, discharge status codes, and DRG assignment.

  • Provide a detailed rationale for every medical record review resulting in a DRG Review Results letter, including supporting references.

  • Follow proper procedure for referral to Clinical Nurse Auditor or Physician Advisor.

  • Utilize proper reference material, standards, and guidelines for coding.

  • Provide input to the Edit Development team on claims selection criteria.

  • Verify data received from client and work to resolve discrepancies.

  • If the contract requires onsite review, interact with Providers and other personnel in a professional manner.

  • Follow policies and processes

  • Comply with department standards regarding productivity and audit quality.

  • Perform other duties as assigned.



To be considered for these challenging roles, applicants must have a majority of the following skills, knowledge and abilities:


  • Possess current AHIMA credentials (RHIT/RHIA/CCS), with current CCS preferred

  • Demonstrate extensive knowledge of ICD-9-CM coding and DRG reimbursement, with a minimum of five years of inpatient coding experience

  • Have an understanding of Medicare, Medicaid, and commercial provider reimbursement methodologies, and possess strong data analysis skills

  • Working knowledge of computer functions and applications such as Microsoft Office (Outlook, Word, Excel) and Windows operating systems

  • Ability to write a well-reasoned review in a narrative style, with accurate spelling, grammar, punctuation, and sentence structure

  • Ability to adapt to changing priorities in order to meet Client requirements and productivity standards and deadlines

  • Ability to travel for additional training and on-site reviews on an as-needed basis

  • Since incumbents will work from their home-based offices, they must have their own access to high-speed Internet connectivity