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Drg Reviewer Jobs (NOW HIRING)

MedReview

DRG Reviewer

Manhattan, NY · On-site +1

$85K - $90K/yr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Under the direction of the DRG Operations leadership team, the DRG Reviewer conducts reviews of inpatient claims to ensure coding accuracy and appropriate DRG assignment while identifying cases ...

MedReview

DRG Reviewer

Manhattan, NY · Remote

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Under the direction of the DRG Operations leadership team, the DRG Reviewer conducts reviews of inpatient claims to ensure coding accuracy and appropriate DRG assignment while identifying cases ...

Centene

DRG Reviewer

Jefferson City, MO · On-site +1

$70K - $126K/yr

  • Medical

  • Retirement

  • PTO

Responsible for independently conducting comprehensive reviews of MS-DRG and APR-DRG coding and clinical documentation to ensure the accuracy of DRG assignment and reimbursement. Requires advanced ...

Centene

DRG Reviewer

Saint Louis, MO · On-site +1

$70K - $126K/yr

  • Medical

  • Retirement

  • PTO

Responsible for independently conducting comprehensive reviews of MS-DRG and APR-DRG coding and clinical documentation to ensure the accuracy of DRG assignment and reimbursement. Requires advanced ...

Centene

DRG Reviewer

Kansas City, MO · On-site +1

$70K - $126K/yr

  • Medical

  • Retirement

  • PTO

Responsible for independently conducting comprehensive reviews of MS-DRG and APR-DRG coding and clinical documentation to ensure the accuracy of DRG assignment and reimbursement. Requires advanced ...

Centene

DRG Reviewer

$70K - $126K/yr

  • Medical

  • Retirement

  • PTO

Responsible for independently conducting comprehensive reviews of MS-DRG and APR-DRG coding and clinical documentation to ensure the accuracy of DRG assignment and reimbursement. Requires advanced ...

Centene

DRG Reviewer

Columbia, MO · On-site +1

$70K - $126K/yr

  • Medical

  • Retirement

  • PTO

Responsible for independently conducting comprehensive reviews of MS-DRG and APR-DRG coding and clinical documentation to ensure the accuracy of DRG assignment and reimbursement. Requires advanced ...

Centene

DRG Reviewer

Florissant, MO · On-site +1

$70K - $126K/yr

  • Medical

  • Retirement

  • PTO

Responsible for independently conducting comprehensive reviews of MS-DRG and APR-DRG coding and clinical documentation to ensure the accuracy of DRG assignment and reimbursement. Requires advanced ...

Machinify

DRG Reviewer

$35.50 - $47.75/hr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

About the Opportunity As part of the Complex Payment Solutions Team, you will, as a DRG Reviewer, be a key contributor responsible for conducting thorough DRG payment validation reviews, including ...

Machinify

DRG Reviewer

$90K - $115K/yr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

About the Opportunity As part of the Complex Payment Solutions Team, you will, as a DRG Reviewer, be a key contributor responsible for conducting thorough DRG payment validation reviews, including ...

Zelis

Inpatient DRG Reviewer

Boston, MA

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Conduct reviews on inpatient DRG claims as they compare with medical records ICD-10 Official Coding Guidelines, AHA Coding Clinic and client specific coverage policies. Conduct prompt claim review to ...

Zelis

Inpatient DRG Reviewer

Saint Petersburg, FL

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Conduct reviews on inpatient DRG claims as they compare with medical records ICD-10 Official Coding Guidelines, AHA Coding Clinic and client specific coverage policies. Conduct prompt claim review to ...

Zelis

Inpatient DRG Reviewer

Saint Petersburg, FL · On-site

$79K - $99K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Conduct reviews on inpatient DRG claims as they compare with medical records ICD-10 Official Coding Guidelines, AHA Coding Clinic and client specific coverage policies. Conduct prompt claim review to ...

Zelis

Inpatient DRG Reviewer

Saint Louis, MO · On-site

$79K - $99K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Conduct reviews on inpatient DRG claims as they compare with medical records ICD-10 Official Coding Guidelines, AHA Coding Clinic and client specific coverage policies. Conduct prompt claim review to ...

Zelis

Inpatient DRG Reviewer

Plano, TX

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Conduct reviews on inpatient DRG claims as they compare with medical records ICD-10 Official Coding Guidelines, AHA Coding Clinic and client specific coverage policies. Conduct prompt claim review to ...

Zelis

Inpatient DRG Reviewer

Boston, MA · On-site

$79K - $99K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Conduct reviews on inpatient DRG claims as they compare with medical records ICD-10 Official Coding Guidelines, AHA Coding Clinic and client specific coverage policies. Conduct prompt claim review to ...

Zelis

Inpatient DRG Reviewer

Atlanta, GA · On-site

$79K - $99K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Conduct reviews on inpatient DRG claims as they compare with medical records ICD-10 Official Coding Guidelines, AHA Coding Clinic and client specific coverage policies. Conduct prompt claim review to ...

Zelis

Inpatient DRG Reviewer

Plano, TX · On-site

$79K - $99K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Conduct reviews on inpatient DRG claims as they compare with medical records ICD-10 Official Coding Guidelines, AHA Coding Clinic and client specific coverage policies. Conduct prompt claim review to ...

Zelis

Inpatient DRG Reviewer

Saint Louis, MO

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Conduct reviews on inpatient DRG claims as they compare with medical records ICD-10 Official Coding Guidelines, AHA Coding Clinic and client specific coverage policies. Conduct prompt claim review to ...

Zelis

Inpatient DRG Reviewer

Morristown, NJ · On-site

$79K - $99K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Conduct reviews on inpatient DRG claims as they compare with medical records ICD-10 Official Coding Guidelines, AHA Coding Clinic and client specific coverage policies. Conduct prompt claim review to ...

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Drg Reviewer information

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$29

$48

How much do drg reviewer jobs pay per hour?

As of Aug 18, 2026, the average hourly pay for drg reviewer in the United States is $29.88, according to ZipRecruiter salary data. Most workers in this role earn between $22.60 and $36.54 per hour, depending on experience, location, and employer.

What is a DRG reviewer?

A DRG Reviewer is a healthcare professional who evaluates patient medical records to ensure accurate assignment of Diagnosis-Related Groups (DRGs) for billing and reimbursement purposes. They review clinical documentation, verify coding accuracy, and ensure compliance with regulations and guidelines. DRG Reviewers play a crucial role in optimizing hospital revenue while maintaining adherence to healthcare standards. Their work supports accurate hospital payments and helps prevent billing errors or fraud.

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

As a DRG Reviewer, collaboration with both clinical staff and medical coders is essential for ensuring accurate assignment of Diagnosis-Related Groups (DRGs) and appropriate reimbursement. DRG Reviewers regularly communicate with physicians to clarify clinical documentation and work closely with coding teams to resolve discrepancies or ambiguities in medical records. This role often involves participating in interdisciplinary meetings, educating staff on documentation requirements, and providing feedback to improve coding accuracy, which helps maintain compliance and optimize hospital revenue.

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

To thrive as a DRG Reviewer, you need a solid background in medical coding, clinical documentation, and healthcare reimbursement, often supported by credentials such as RHIA, RHIT, CCS, or RN licensure. Familiarity with ICD-10-CM/PCS codes, MS-DRG grouping software, and hospital information systems is typically required. Attention to detail, analytical thinking, and effective communication are valuable soft skills for ensuring accurate coding and collaboration with clinical staff. These skills are crucial for optimizing reimbursement, maintaining regulatory compliance, and supporting quality healthcare delivery.
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What job categories do people searching Drg Reviewer jobs look for?

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Drg Reviewer jobs near you
Infographic showing various Drg Reviewer job openings in the United States as of August 2026, with employment types broken down into 100% Full Time. Highlights an 67% In-person, and 33% Remote job distribution, with an average salary of $62,159 per year, or $29.9 per hour.

DRG Reviewer

MedReview

Manhattan, NY • On-site, Remote

$85K - $90K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 12 days ago

Job description

Position Summary
At MedReview, our mission is to bring accuracy, accountability, and clinical excellence to healthcare. We are a leading authority in payment integrity solutions, including DRG Validation, Cost Outlier, and Readmission Reviews.
Under the direction of the DRG Operations leadership team, the DRG Reviewer conducts reviews of inpatient claims to ensure coding accuracy and appropriate DRG assignment while identifying cases requiring clinical review to support coded diagnoses.
This is a fully remote position. Candidates must be available to work Eastern Standard Time (EST) business hours.
Salary: $85,000-$90,000 annually, commensurate with experience.
Responsibilities:
  • Analyze and review inpatient claims following the Official Coding and Reporting Guidelines to validate the reported ICD-10-CM/PCS codes to ensure proper DRG assignment for accurate billing.
  • Demonstrates the ability to perform a comprehensive initial review as outlined in the standard operating procedures and departmental guides.
  • Collaborates with physician reviewers, as needed.
  • Ability to prioritize and organize workload and complete tasks independently.
  • Required attendance of all departmental team meetings and/or training.
  • Work on other duties or tasks, as necessary.

Performance Expectations:
  • Report productivity daily utilizing department productivity report.
  • Meet/exceed daily productivity expectations.
  • Maintains 95% accuracy in claim reviews.
  • Must be available to work a 7.5-hour workday during Eastern Standard Time (EST) business hours.
  • Comply with organization policy and procedures.

Qualifications:
  • Coding Certification required (at least one of the following is required and must be maintained as a condition of employment).
    • Certified Coding Specialist (CCS)
    • Certified Inpatient Coder (CIC)
    • Registered Heath Information Technician (RHIT)
  • College level courses in medical terminology, anatomy, pathophysiology, pharmacology, and medical coding courses.
  • At least 3 years' experience in MS-DRG and APR-DRG validation in acute care inpatient coding, auditing. Payment integrity DRG validation is a plus.
  • Adherence to the Official Coding and Reporting guidelines, AHA Coding Clinic determinations, and CMS and other regulatory compliance guidelines and mandates.
  • Requires working knowledge of applicable industry-based standards.
  • Proficiency in Outlook, Word, Excel, and other applications.
  • Excellent written and verbal communication skills.
  • Maintain professional credentialed status with approved continuing education programs
  • Ability to work independently and can multi-task or transition to different tasks easily.
Remote Work Requirements:
  • High speed internet (100 Mbps per person recommended) with secured WIFI.
  • A dedicated workspace with minimal interruptions to protect PHI and HIPAA information.
  • Must be able to sit and use a computer keyboard for extended periods of time.

Benefits and perks include:
  • Healthcare that fits your needs - We offer excellent medical, dental, and vision plan options that provide coverage to employees and dependents.
  • 401(k) with Employer Match - Join the team and we will invest in your future
  • Generous Paid Time Off - Accrued PTO starting day one, plus additional days off when you're not feeling well, to observe holidays.
  • Wellness - We care about your well-being. From Commuter Benefits to FSAs we've got you covered.
  • Learning & Development - Through continued education/mentorship on the job and our investment in LinkedIn Learning, we're focused on your growth as a working professional.

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