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Drg Validation Reviewer Jobs (NOW HIRING)

MedReview

DRG Reviewer

Manhattan, NY · On-site +1

$85K - $90K/yr

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.

MedReview

DRG Reviewer

Manhattan, NY · Remote

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.

Jzanus Consulting

DRG Validator- Remote

Garden City, NY · Remote

$85K/yr

Key Responsibilities Perform concurrent and retrospective clinically based and MS-DRG and APR DRG validation reviews in compliance with appropriate coding and payments adhering to Uniform Hospital ...

MMC Group

DRG Auditor

San Antonio, TX · Remote

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 ...

Med Review Inc

Physician Reviewer

Manhattan, NY · On-site

Perform DRG Clinical Validation reviews to ensure diagnoses are accurate, supported, and compliant * Evaluate medical records, diagnostic findings, and treatment plans using evidence-based guidelines

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 ...

R1

DRG Validation Auditor I

$48K - $81K/yr

Review inpatient medical records for validation of DRG assignment * Provide detailed rationale and supporting evidence for the recommendation and findings * Utilize industry-recognized references to ...

MedReview

Physician Reviewer

Manhattan, NY · On-site +1

Perform DRG Clinical Validation reviews to ensure diagnoses are accurate, supported, and compliant * Evaluate medical records, diagnostic findings, and treatment plans using evidence-based guidelines

HCA Healthcare

DRG Validation Auditor

Portsmouth, NH · On-site

You will review outcomes are communicated to the HSC team to improve the accuracy, integrity and ... our DRG Validation Auditor opening. We promptly review all applications. Highly qualified ...

MedReview

Physician Reviewer

Manhattan, NY · Remote

Perform DRG Clinical Validation reviews to ensure diagnoses are accurate, supported, and compliant * Evaluate medical records, diagnostic findings, and treatment plans using evidence-based guidelines

HCA Healthcare

DRG Validation Auditor

Frankfort, KY · On-site

You will review outcomes are communicated to the HSC team to improve the accuracy, integrity and ... our DRG Validation Auditor opening. We promptly review all applications. Highly qualified ...

HCA Healthcare

DRG Validation Auditor

Socorro, TX · On-site

You will review outcomes are communicated to the HSC team to improve the accuracy, integrity and ... our DRG Validation Auditor opening. We promptly review all applications. Highly qualified ...

Parallon

DRG Validation Auditor

Lebanon, TN · On-site

You will review outcomes are communicated to the HSC team to improve the accuracy, integrity and ... our DRG Validation Auditor opening. We promptly review all applications. Highly qualified ...

HCA Healthcare

DRG Validation Auditor

El Paso, TX · On-site

You will review outcomes are communicated to the HSC team to improve the accuracy, integrity and ... our DRG Validation Auditor opening. We promptly review all applications. Highly qualified ...

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How much do drg validation reviewer jobs pay per hour?

As of Jul 27, 2026, the average hourly pay for drg validation reviewer in the United States is $52.00, according to ZipRecruiter salary data. Most workers in this role earn between $39.42 and $63.22 per hour, depending on experience, location, and employer.

What are some typical challenges faced by DRG Validation Reviewers, and how are they addressed?

DRG Validation Reviewers often face challenges such as interpreting complex clinical documentation, keeping up with frequently changing coding regulations, and handling discrepancies between physician notes and assigned codes. These challenges are typically addressed through continuous education, regular team collaboration, and access to updated coding resources and clinical guidelines. Reviewers also work closely with physicians, coding staff, and compliance teams to resolve ambiguities and ensure the most accurate DRG assignments. By leveraging their expertise and staying current with industry changes, DRG Validation Reviewers help protect healthcare organizations from compliance issues and financial inaccuracies.

What are the key skills and qualifications needed to thrive in the Drg Validation Reviewer position, and why are they important?

To thrive as a DRG Validation Reviewer, you need a strong understanding of medical coding, clinical documentation, and healthcare reimbursement methodologies, usually backed by credentials like CPC, RHIA, or CCS. Familiarity with coding software, EHR systems, and DRG grouper tools is typically required. Strong analytical thinking, keen attention to detail, and effective communication skills are vital soft skills in this position. These competencies ensure accurate validation of diagnosis-related groups, minimize compliance risks, and support proper hospital reimbursement.

What is a DRG Validation Reviewer job?

A DRG Validation Reviewer is responsible for reviewing medical records to ensure the accuracy of Diagnosis-Related Group (DRG) assignments. They analyze documentation to validate coding accuracy, compliance with healthcare regulations, and appropriate reimbursement for hospital services. Their role helps prevent fraud, reduce claim denials, and ensure proper billing practices. Typically, they work with healthcare providers, insurance companies, or auditing firms to maintain financial and regulatory integrity. Strong knowledge of medical coding (ICD-10-CM/PCS), billing, and healthcare guidelines is essential for this role.

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What cities are hiring for Drg Validation Reviewer jobs? Cities with the most Drg Validation Reviewer job openings:
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Drg Validation Reviewer jobs near you
Infographic showing various Drg Validation Reviewer job openings in the United States as of July 2026, with employment types broken down into 2% As Needed, 91% Full Time, 5% Part Time, and 2% Contract. Highlights an 73% Physical, 1% Hybrid, and 26% Remote job distribution, with an average salary of $108,152 per year, or $52 per hour.
DRG Reviewer

DRG Reviewer

MedReview

Manhattan, NY • On-site, Remote

$85K - $90K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 20 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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