ZipRecruiter

Log In

1

Drg Validation Jobs (NOW HIRING)

MedReview

DRG Clinical Validation Nurse

Manhattan, NY · On-site +1

$85K - $95K/yr

... DRG Validation, Cost Outlier and Readmission reviews. We are seeking a registered nurse with experience in clinical validation to work within our coding department. Candidate should be highly ...

Machinify, Inc.

DRG ManagerRemote

$7.25/hr

As part of the Complex Payment Solutions Team, you will, as the DRG Manager, be responsible for the development and management of our clinical solutions, including MS and APR-DRG validation. This ...

EnableComp

DRG Validator/Reviewer (REMOTE)

OR · Remote

Certified Coding Specialist (CCS) certification required. * 2-3 years' experience in DRG validation, inpatient medical coding, or related coding review. * Strong understanding of ICD-10-CM/PCS coding ...

EnableComp

DRG Validator/Reviewer (REMOTE)

Franklin, TN · Remote

Certified Coding Specialist (CCS) certification required. * 2-3 years' experience in DRG validation, inpatient medical coding, or related coding review. * Strong understanding of ICD-10-CM/PCS coding ...

EnableComp

DRG Validator/Reviewer (REMOTE)

Franklin, TN · Remote

Certified Coding Specialist (CCS) certification required. * 2-3 years' experience in DRG validation, inpatient medical coding, or related coding review. * Strong understanding of ICD-10-CM/PCS coding ...

EnableComp

DRG Validator/Reviewer (REMOTE)

OR · Remote

Certified Coding Specialist (CCS) certification required. * 2-3 years' experience in DRG validation, inpatient medical coding, or related coding review. * Strong understanding of ICD-10-CM/PCS coding ...

EnableComp

DRG Validator/Reviewer (REMOTE)

Certified Coding Specialist (CCS) certification required. * 2-3 years' experience in DRG validation, inpatient medical coding, or related coding review. * Strong understanding of ICD-10-CM/PCS coding ...

EnableComp

DRG Validator/Reviewer (REMOTE)

Franklin, TN · On-site

Certified Coding Specialist (CCS) certification required. * 2-3 years' experience in DRG validation, inpatient medical coding, or related coding review. * Strong understanding of ICD-10-CM/PCS coding ...

Astrana Health, Inc.

$33 - $38/hr

DRG Coder Department: HS - UM Employment Type: Full Time Location: 600 City Parkway West 10th Floor ... Conduct coding validation and auditing to ensure compliance with payer and regulatory requirements

Astrana Health

DRG Coder

$33 - $38/hr

DRG Coder The Senior DRG Coder is responsible for reviewing inpatient medical records and ... Conduct coding validation and auditing to ensure compliance with payer and regulatory requirements

Zelis

Ops Analyst, DRG

Boston, MA · On-site

Position Overview The Operations Analyst, DRG will provide daily operational support to the Expert Claims Review team, including the itemized bill review and DRG validation teams. Responsibilities ...

Zelis

Ops Analyst, DRG

Morristown, NJ · On-site

Position Overview The Operations Analyst, DRG will provide daily operational support to the Expert Claims Review team, including the itemized bill review and DRG validation teams. Responsibilities ...

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 ...

New

Zelis

Ops Analyst, DRG

Atlanta, GA

Position Overview The Operations Analyst, DRG will provide daily operational support to the Expert Claims Review team, including the itemized bill review and DRG validation teams. Responsibilities ...

previous pagenext page

Showing results 21-40

All JobsDrg Validation Jobs

Drg Validation information

See salary details

$15

$26

$45

How much do drg validation jobs pay per hour?

As of Aug 6, 2026, the average hourly pay for drg validation in the United States is $26.09, according to ZipRecruiter salary data. Most workers in this role earn between $19.23 and $30.53 per hour, depending on experience, location, and employer.

What is DRG validation?

DRG validation is the process of reviewing medical records and clinical documentation to ensure that the assigned Diagnosis-Related Group (DRG) code accurately reflects the patient's diagnoses and procedures during a hospital stay. This process is crucial for accurate hospital reimbursement, compliance with regulations, and maintaining data integrity. DRG validation helps detect and correct coding errors, supports quality reporting, and prevents potential billing issues or audits.

What does a Drg validation do?

A DRG validation specialist reviews and verifies Diagnosis-Related Group (DRG) coding to ensure accurate hospital billing and reimbursement. They analyze medical records, confirm proper coding, and may use coding software to maintain compliance with healthcare regulations.

What are the typical challenges faced in a DRG validation role, and how can professionals effectively address them?

DRG Validation professionals often encounter challenges such as ensuring accurate clinical documentation, interpreting complex medical records, and staying current with changing coding guidelines and regulations. To effectively address these challenges, it's important to maintain ongoing education, collaborate closely with clinical staff to clarify documentation, and utilize robust auditing tools. A strong attention to detail and proactive communication with healthcare providers help ensure the integrity of data and compliance with industry standards.

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

To excel as a DRG Validator, you need a strong understanding of medical coding, clinical documentation, and healthcare regulations, usually backed by a credential such as RHIT, CCS, or CPC. Familiarity with coding classification systems (ICD-10-CM/PCS), DRG grouping software, and electronic health record (EHR) systems is essential. Attention to detail, analytical thinking, and effective communication are crucial soft skills for ensuring coding accuracy and collaborating with clinical staff. These skills ensure correct reimbursement, compliance with regulations, and support the financial health of healthcare organizations.

What is the difference between Drg Validation vs Medical Coder?

AspectDrg ValidationMedical Coder
CredentialsTypically requires coding certifications and knowledge of DRG systemsRequires coding certifications like CPC, CCS, or equivalent
Work EnvironmentHospitals, insurance companies, or healthcare consulting firmsHospitals, clinics, and billing companies
Industry UsageFocuses on validating DRG assignments for reimbursementFocuses on assigning accurate medical codes for diagnoses and procedures
Search/Comparison IntentUnderstanding DRG validation roles and responsibilitiesUnderstanding medical coding roles and responsibilities

Drg Validation specialists focus on verifying DRG assignments for billing and reimbursement, requiring knowledge of coding and healthcare regulations. Medical Coders assign specific medical codes to diagnoses and procedures, often requiring similar certifications. While both roles involve coding, Drg Validation emphasizes DRG accuracy for reimbursement, whereas Medical Coders handle detailed coding tasks across various medical documentation.

More about Drg Validation jobs
What cities are hiring for Drg Validation jobs? Cities with the most Drg Validation job openings:
What are the most commonly searched types of Drg Validation jobs? The most popular types of Drg Validation jobs are:
What states have the most Drg Validation jobs? States with the most job openings for Drg Validation jobs include:
What job categories do people searching Drg Validation jobs look for? The top searched job categories for Drg Validation jobs are:
Drg Validation jobs near you
Infographic showing various Drg Validation 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 $54,267 per year, or $26.1 per hour.

DRG Clinical Validation Nurse

MedReview

Manhattan, NY • On-site, Remote

$85K - $95K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 22 days ago

Job description

Position Summary
At MedReview, our mission is to bring accuracy, accountability, and clinical excellence to healthcare. As such, we are a leading authority in payment integrity solutions including DRG Validation, Cost Outlier and Readmission reviews. We are seeking a registered nurse with experience in clinical validation to work within our coding department.
Candidate should be highly motivated, with strong clinical and coding background. This individual must have excellent communication skills and an analytical mindset to achieve and maintain high-level performance in a fast-paced environment.
This is a fulltime position (40 hours per week) Monday - Friday. You'll enjoy the flexibility to telecommute from anywhere within the United States. Training will be conducted virtually from your home.
If you are interested in this role with MedReview, please let us know. Here is what we are searching for:
Responsibilities:
  • Perform clinical validation by ensuring diagnosis codes billed by the provider are supported within the medical record
  • Must be able to interpret clinical guidelines/criteria and apply to clinical review
  • Solid understanding of anatomy and physiology, diagnostic and surgical procedures developed from specialized training and extensive experience with ICD-10-PCS code assignments
  • Demonstrates the ability to accurately interpret the medical record
  • Writes clear, accurate and concise rationales in support of findings
  • 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 terminology, and regulatory guidelines

Qualifications:
  • Minimum of two years' experience in clinical validation in a payment integrity setting required
  • May consider nurses with inpatient claims auditing experience or case management experience.
  • Unrestricted Registered Nurse with active RN licensure required
  • CCS (Certified Coding Specialist) or CIC (Certified Inpatient Coder) certification preferred
  • CCDS or CDIP Certification preferred
  • Knowledge of ICD-10 coding
  • Basic Knowledge of DRG validation and coding
  • Ability to use Windows PC with the ability to utilize multiple applications at the same time

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.

Salary Rate: $85,000 - 95,000/Annually.

Apply