ZipRecruiter

Log In

1

Drg Validation Reviewer Jobs (NOW HIRING)

MedReview

DRG Clinical Validation Nurse

New York, NY · Remote

$85K - $95K/yr

Maintains and manages case reviews with a high emphasis on quality * Demonstrates the ability to work in a high - volume production environment * Knowledge of health insurance business, industry ...

MedReview

DRG Clinical Validation Nurse

Manhattan, NY · On-site +1

$85K - $95K/yr

Maintains and manages case reviews with a high emphasis on quality * Demonstrates the ability to work in a high - volume production environment * Knowledge of health insurance business, industry ...

Cotiviti

DRG Validation Auditor (Clinical & Coding)

$45.67/hr

... DRG Validation). The ideal candidate for this position needs to have both a clinical (nurse) and a ... clinical review, coding accuracy, and the appropriateness of treatment setting and services ...

Cotiviti

$45.67/hr

... DRG Validation). The ideal candidate for this position needs to have both a clinical (nurse) and a ... clinical review, coding accuracy, and the appropriateness of treatment setting and services ...

CorroHealth

DRG Revenue Integrity Auditor - REMOTE

Perform detailed DRG validation reviews of inpatient charts. * Ensure assigned ICD-10-CM/PCS codes accurately reflect the patient's clinical condition and treatment. * Validate proper sequencing and ...

ISLAND PEER REVIEW CORP

Coding Reviewer

Jericho, NY · On-site

$65K - $70K/yr

As a Coding Reviewer, you will be responsible for the general coding validation and verification ... Confirm and verify submitted codes for DRG validation. * Apply national coding standards and ...

IPRO

Coding Reviewer

Jericho, NY · On-site

Duties include but are not limited to: • Confirm and verify submitted codes for DRG validation ... utilization reviews preferred. The salary range and/or hourly rate listed is a good faith ...

Astrana Health, Inc.

$33 - $38/hr

Review inpatient hospital records and assign accurate diagnosis and procedure codes * Determine the ... Conduct coding validation and auditing to ensure compliance with payer and regulatory requirements

EnableComp

DRG Auditor (REMOTE)

Franklin, TN · On-site

$27 - $30.50/hr

Position Summary The DRG Auditor is responsible for reviewing post-billed inpatient claims to identify and validate missed reimbursement opportunities based on diagnosis and procedure coding. Working ...

EnableComp

DRG Auditor (REMOTE)

$28 - $31.75/hr

Position Summary The DRG Auditor is responsible for reviewing post-billed inpatient claims to identify and validate missed reimbursement opportunities based on diagnosis and procedure coding. Working ...

Machinify

DRG Reviewer

$35.50 - $47.75/hr

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 ...

previous page

Showing results 41-60

All JobsDrg Validation Reviewer Jobs

Drg Validation Reviewer information

See salary details

$22

$51

$78

How much do drg validation reviewer jobs pay per hour?

As of Aug 9, 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 as a Drg Validation Reviewer?

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?

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.

More about Drg Validation Reviewer jobs
What cities are hiring for Drg Validation Reviewer jobs? Cities with the most Drg Validation Reviewer job openings:
What are the most commonly searched types of Drg Validation Reviewer jobs? The most popular types of Drg Validation Reviewer jobs are:
What states have the most Drg Validation Reviewer jobs? States with the most job openings for Drg Validation Reviewer jobs include:
What job categories do people searching Drg Validation Reviewer jobs look for? The top searched job categories for Drg Validation Reviewer jobs are:
Drg Validation Reviewer jobs near you
Infographic showing various Drg Validation Reviewer job openings in the United States as of August 2026, with employment types broken down into 90% Full Time, 3% Part Time, 1% Temporary, and 6% Contract. Highlights an 87% Physical, 4% Hybrid, and 9% Remote job distribution, with an average salary of $108,152 per year, or $52 per hour.

RN, DRG Coder / Clinical Auditor

Pivotal Placement Services

Biloxi, MS • Remote

$95K - $105K/yr

Full-time

Posted 5 days ago

Job description

RN, DRG Coder / Clinical Auditor
Must be a Registered Nurse with experience

📍 Remote | Full-Time | 🏥 Healthcare | Clinical Documentation & Coding

About the Role

We’re seeking a detail-oriented DRG Coder/Clinical Auditor to perform DRG validation reviews of medical records and documentation. This role ensures accurate coding and clinical support for DRG assignments, helping improve billing accuracy, reimbursement, and compliance. You’ll work independently to review records, validate coding, and communicate findings clearly and professionally.

Key Responsibilities

  • Chart Review & Validation
    Review medical records to validate DRG assignments and ensure clinical documentation supports coding decisions.

  • Physician Documentation Review
    Confirm that physician notes and clinical indicators support assigned DRGs.

  • Audit & Compliance
    Conduct audits to verify coding accuracy, enhance reimbursement, and identify cost-saving opportunities.

  • Coding Expertise
    Apply ICD-10-CM and PCS coding guidelines, payer rules, and regulatory standards (Medicare, Medicaid, CMS).

  • Communication & Reporting
    Clearly document findings and communicate results in a professional and concise manner.

  • Other Duties
    Support additional documentation and coding-related tasks as assigned.

Qualifications
  • Licensure: RN
  • Experience:
    • Minimum 1 year of recent DRG auditing experience in a hospital or health plan setting.
    • Inpatient ICD-10 coding experience required.
    • CDI candidates are encouraged to apply.
  • Certifications:
    • National coding certification through AHIMA (preferred) or AAPC.
    • CCS or CIC strongly preferred.
  • Technical Skills:
    • Proficient in MS and APR DRG methodology.
    • Familiarity with Coding Clinic citations and Official Coding Guidelines.
    • Strong understanding of Medicare/CMS documentation requirements.
  • Soft Skills:
    • Exceptional attention to detail.
    • Strong problem-solving and critical thinking abilities.
    • Effective verbal and written communication.
    • Ability to work independently in a fast-paced, production-driven environment.
  • Tools:
    • Proficient in Microsoft Office Suite.
Compensation

💵 Pay Range: $90,000 – $104,841
Salary is based on location, experience, qualifications, and internal equity. Final compensation may vary depending on assessment during the interview process.

Who We Are

Headquartered in Central Florida, Pivotal Placement Services is a full-service national workforce solutions firm that specializes in placing healthcare professionals—from staff to leadership—with both clinical and non-clinical employers. Our comprehensive and customer-focused workforce solutions include Direct Placement and Managed Service Provider (MSP) / Vendor Managed Services (VMS) engagements nationwide.