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.
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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.
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.
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.
DIAGNOSIS RELATED GROUP SPECIALIST (JR230306)
Tarrytown, NY · On-site
$60 - $80/hr
Overview The DRG Validator is a coding quality and compliance professional responsible for conducting complex and high-impact coding audits across inpatient (IP) encounters. Responsibilities
DIAGNOSIS RELATED GROUP SPECIALIST (JR230306)
Tarrytown, NY · On-site
$60 - $80/hr
Overview The DRG Validator is a coding quality and compliance professional responsible for conducting complex and high-impact coding audits across inpatient (IP) encounters. Responsibilities
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 ...
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 ...
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 ...
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 ...
DRG Validation Auditor
Las Vegas, NV · On-site
$34.59 - $51.89/hr
As a DRG Validation Auditor with Parallon you can be a part of an organization that is devoted to giving back! Candidates must have a background in Facility Inpatient Coding and DRG Validation. Job ...
DRG Validation Auditor
Las Vegas, NV · On-site
$34.59 - $51.89/hr
As a DRG Validation Auditor with Parallon you can be a part of an organization that is devoted to giving back! Candidates must have a background in Facility Inpatient Coding and DRG Validation. Job ...
DRG Validation Auditor
Portsmouth, NH · On-site
As a DRG Validation Auditor with Parallon you can be a part of an organization that is devoted to giving back! Candidates must have a background in Facility Inpatient Coding and DRG Validation. Job ...
DRG Validation Auditor
Portsmouth, NH · On-site
As a DRG Validation Auditor with Parallon you can be a part of an organization that is devoted to giving back! Candidates must have a background in Facility Inpatient Coding and DRG Validation. Job ...
DRG Validation Auditor
Sunland Park, NM · On-site
As a DRG Validation Auditor with Parallon you can be a part of an organization that is devoted to giving back! Candidates must have a background in Facility Inpatient Coding and DRG Validation. Job ...
DRG Validation Auditor
Sunland Park, NM · On-site
As a DRG Validation Auditor with Parallon you can be a part of an organization that is devoted to giving back! Candidates must have a background in Facility Inpatient Coding and DRG Validation. Job ...
DRG Validation Auditor
Chattanooga, TN · On-site
As a DRG Validation Auditor with Parallon you can be a part of an organization that is devoted to giving back! Candidates must have a background in Facility Inpatient Coding and DRG Validation. Job ...
DRG Validation Auditor
Chattanooga, TN · On-site
As a DRG Validation Auditor with Parallon you can be a part of an organization that is devoted to giving back! Candidates must have a background in Facility Inpatient Coding and DRG Validation. Job ...
DRG Validation Auditor
Orlando, FL · On-site
As a DRG Validation Auditor with Parallon you can be a part of an organization that is devoted to giving back! Candidates must have a background in Facility Inpatient Coding and DRG Validation. Job ...
DRG Validation Auditor
Orlando, FL · On-site
As a DRG Validation Auditor with Parallon you can be a part of an organization that is devoted to giving back! Candidates must have a background in Facility Inpatient Coding and DRG Validation. Job ...
DRG Validation Auditor
Nashville, TN · On-site
As a DRG Validation Auditor with Parallon you can be a part of an organization that is devoted to giving back! Candidates must have a background in Facility Inpatient Coding and DRG Validation. Job ...
DRG Validation Auditor
Nashville, TN · On-site
As a DRG Validation Auditor with Parallon you can be a part of an organization that is devoted to giving back! Candidates must have a background in Facility Inpatient Coding and DRG Validation. Job ...
DRG Validation Auditor
Nashville, TN · On-site
As a DRG Validation Auditor with Parallon you can be a part of an organization that is devoted to giving back! Candidates must have a background in Facility Inpatient Coding and DRG Validation. Job ...
DRG Validation Auditor
Nashville, TN · On-site
As a DRG Validation Auditor with Parallon you can be a part of an organization that is devoted to giving back! Candidates must have a background in Facility Inpatient Coding and DRG Validation. Job ...
DRG Validation Auditor
Jacksonville, FL · On-site
As a DRG Validation Auditor with Parallon you can be a part of an organization that is devoted to giving back! Candidates must have a background in Facility Inpatient Coding and DRG Validation. Job ...
DRG Validation Auditor
Jacksonville, FL · On-site
As a DRG Validation Auditor with Parallon you can be a part of an organization that is devoted to giving back! Candidates must have a background in Facility Inpatient Coding and DRG Validation. Job ...
DRG Validation Auditor
Horizon City, TX · On-site
As a DRG Validation Auditor with Parallon you can be a part of an organization that is devoted to giving back! Candidates must have a background in Facility Inpatient Coding and DRG Validation. Job ...
DRG Validation Auditor
Horizon City, TX · On-site
As a DRG Validation Auditor with Parallon you can be a part of an organization that is devoted to giving back! Candidates must have a background in Facility Inpatient Coding and DRG Validation. Job ...
DRG Validation Auditor
Lebanon, TN · On-site
As a DRG Validation Auditor with Parallon you can be a part of an organization that is devoted to giving back! Candidates must have a background in Facility Inpatient Coding and DRG Validation. Job ...
DRG Validation Auditor
Lebanon, TN · On-site
As a DRG Validation Auditor with Parallon you can be a part of an organization that is devoted to giving back! Candidates must have a background in Facility Inpatient Coding and DRG Validation. Job ...
DRG Validation Auditor
Murfreesboro, TN · On-site
As a DRG Validation Auditor with Parallon you can be a part of an organization that is devoted to giving back! Candidates must have a background in Facility Inpatient Coding and DRG Validation. Job ...
DRG Validation Auditor
Murfreesboro, TN · On-site
As a DRG Validation Auditor with Parallon you can be a part of an organization that is devoted to giving back! Candidates must have a background in Facility Inpatient Coding and DRG Validation. Job ...
DRG Validation Coding Auditor
$69K - $104K/yr
The Inpatient/DRG Validation Coding Auditor performs documentation and coding audits for all acute inpatient services for clients. Identifies coding errors, compliance, and educational opportunities ...
DRG Validation Coding Auditor
$69K - $104K/yr
The Inpatient/DRG Validation Coding Auditor performs documentation and coding audits for all acute inpatient services for clients. Identifies coding errors, compliance, and educational opportunities ...
DRG Validation Auditor
Caldwell, ID · On-site
$34.59 - $51.89/hr
As a DRG Validation Auditor with Parallon you can be a part of an organization that is devoted to giving back! Candidates must have a background in Facility Inpatient Coding and DRG Validation. Job ...
DRG Validation Auditor
Caldwell, ID · On-site
$34.59 - $51.89/hr
As a DRG Validation Auditor with Parallon you can be a part of an organization that is devoted to giving back! Candidates must have a background in Facility Inpatient Coding and DRG Validation. Job ...
DRG Reviewer
$70K - $126K/yr
Operates with significant autonomy in supporting DRG validation reviews and appeals, interpreting regulatory requirements, and making authoritative decisions to ensure compliance with all applicable ...
DRG Reviewer
$70K - $126K/yr
Operates with significant autonomy in supporting DRG validation reviews and appeals, interpreting regulatory requirements, and making authoritative decisions to ensure compliance with all applicable ...
DRG Validation Auditor
El Paso, TX · On-site
As a DRG Validation Auditor with Parallon you can be a part of an organization that is devoted to giving back! Candidates must have a background in Facility Inpatient Coding and DRG Validation. Job ...
DRG Validation Auditor
El Paso, TX · On-site
As a DRG Validation Auditor with Parallon you can be a part of an organization that is devoted to giving back! Candidates must have a background in Facility Inpatient Coding and DRG Validation. Job ...
Drg Validator information
What is a DRG Validator?
A DRG Validator reviews and validates Diagnosis-Related Group (DRG) codes assigned to patient records for accuracy and compliance with coding guidelines. They ensure that medical documentation supports the assigned codes, which directly impact hospital reimbursement and reporting. DRG Validators typically work in healthcare facilities, insurance companies, or auditing firms and must have expertise in medical coding, billing regulations, and clinical documentation.
What does a DRG Validator do?
As a DRG Validator, your typical day involves reviewing patient medical records and coding assignments to ensure accurate DRG classification and compliance with coding guidelines. You may collaborate closely with medical coders, clinical documentation improvement specialists, and healthcare providers to clarify documentation or resolve discrepancies. The role often requires you to stay updated on coding regulations and participate in quality assurance meetings. Attention to detail and thorough documentation are essential, as your work directly impacts hospital reimbursement and data integrity.
What are the key skills and qualifications needed to thrive as a DRG Validator?
To thrive as a DRG Validator, you need a strong understanding of medical coding, clinical documentation, and Diagnosis Related Group (DRG) assignment, often supported by an RHIA, RHIT, or CCS certification. Familiarity with coding software (such as 3M or TruCode), electronic medical record (EMR) systems, and current ICD-10-CM/PCS coding standards is essential. Attention to detail, analytical thinking, and effective communication are key soft skills in this position. These abilities are crucial to accurately validate coding, ensure compliance with regulatory standards, and reduce reimbursement errors.
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DRG Reviewer
Manhattan, NY • Remote
MedReview •
Health Care and Social Assistance • 201 - 500 employees201 - 500 employees
Full-time
Medical, Dental, Vision, Retirement, PTO
Re-posted 3 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:
Performance Expectations:
Qualifications:
Benefits and perks include:
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.
- 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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About MedReview
Sourced by ZipRecruiter
Industry
Health care and social assistance
Company size
201 - 500 Employees
Headquarters location
New York, NY, US
Year founded
1974