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On Call Remote Drg Validation Jobs (NOW HIRING)

MMC Group

DRG Auditor

San Antonio, TX · Remote

A leader in providing clinical auditing services to public and commercial healthcare payers throughout the US, has openings for remote DRG Validation Auditors. As members of the DRG Validation Team ...

Jzanus Consulting

DRG Validator- Remote

Garden City, NY · Remote

$85K/yr

The DRG Validation position requires an extensive background in inpatient DRG coding with a deep ... Remote Experience: ICD coding: 5 years (Required) License/Certification:AHIMA Certification ...

MedReview

DRG Reviewer

Manhattan, NY · Remote

... Validation, Cost Outlier, and Readmission Reviews. Under the direction of the DRG Operations ... This is a fully remote position. Candidates must be available to work Eastern Standard Time (EST ...

MedReview

DRG Reviewer

Manhattan, NY · On-site +1

$85K - $90K/yr

... Validation, Cost Outlier, and Readmission Reviews. Under the direction of the DRG Operations ... This is a fully remote position. Candidates must be available to work Eastern Standard Time (EST ...

CGI Inc.

Remote MSDRG Auditor

Atlanta, GA · On-site +1

Remote MSDRG Auditor Category: Analytics and Emerging Digital Technologies Main location: United ... The DRG Validation Auditor is a member of the CGI Healthcare Compliance, DRG Validation Team, with ...

Zelis

Inpatient DRG Sr. Reviewer

Plano, TX · On-site +1

$95K - $120K/yr

Perform comprehensive inpatient DRG validation Quality Assurance reviews to determine accuracy of ... We foster a hybrid and remote friendly culture, and all our employee's work locations are based on ...

Zelis

Inpatient DRG Sr. Reviewer

Atlanta, GA · On-site +1

$95K - $120K/yr

Perform comprehensive inpatient DRG validation Quality Assurance reviews to determine accuracy of ... We foster a hybrid and remote friendly culture, and all our employee's work locations are based on ...

Zelis

Inpatient DRG Sr. Reviewer

Saint Louis, MO · On-site +1

$95K - $120K/yr

Perform comprehensive inpatient DRG validation Quality Assurance reviews to determine accuracy of ... We foster a hybrid and remote friendly culture, and all our employee's work locations are based on ...

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How much do on call remote drg validation jobs pay per hour?

As of Jul 27, 2026, the average hourly pay for on call remote drg validation 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.
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On Call Remote Drg Validation jobs near you
Infographic showing various On Call Remote Drg Validation job openings in the United States as of July 2026, with employment types broken down into 88% Full Time, 6% Part Time, and 6% Contract. Highlights an 100% Remote job distribution, with an average salary of $108,152 per year, or $52 per hour.
DRG Auditor

DRG Auditor

MMC Group

San Antonio, TX • Remote

Full-time

Posted 7 days ago

Job description


Job Description:

A leader in providing clinical auditing services to public and commercial healthcare payers throughout the US, has openings for remote DRG Validation Auditors. 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 rendered to beneficiaries of various health plans, including Commercial, Medicare, and Medicaid Clients. DRG Validation Auditors are charged with rendering appropriate, well-supported, and thoroughly-documented decisions, which may result in identification of improper payments (overpayments and underpayments) on paid claims on behalf of the client from various providers of clinical services, including but not limited to acute care, long-term acute care, acute rehabilitation, and skilled nursing facilities, as well as other provider types and care settings. Initially, DRG Validation Auditors are prepared for the role through a detailed, well-defined training process, gaining knowledge and skills in methods for review of medical records and other provider documentation. Ongoing training and education are provided specific to audit processes, coding and reimbursement changes, and other topics as well. The DRG Validation Auditor reports to a DRG Validation Team Leader, who provides support, feedback, and guidance to DRG Validation Auditors. Moreover, quality assurance is provided through a well-defined review and quality management program performed by the Professional Development Team.


Specifically, DRG Validation Auditors will be responsible for the following:


  • Review inpatient medical records to validate the admit order, assignment and sequencing of ICD9-CM diagnosis and procedure codes, discharge status codes, and DRG assignment.

  • Provide a detailed rationale for every medical record review resulting in a DRG Review Results letter, including supporting references.

  • Follow proper procedure for referral to Clinical Nurse Auditor or Physician Advisor.

  • Utilize proper reference material, standards, and guidelines for coding.

  • Provide input to the Edit Development team on claims selection criteria.

  • Verify data received from client and work to resolve discrepancies.

  • If the contract requires onsite review, interact with Providers and other personnel in a professional manner.

  • Follow policies and processes

  • Comply with department standards regarding productivity and audit quality.

  • Perform other duties as assigned.



To be considered for these challenging roles, applicants must have a majority of the following skills, knowledge and abilities:


  • Possess current AHIMA credentials (RHIT/RHIA/CCS), with current CCS preferred

  • Demonstrate extensive knowledge of ICD-9-CM coding and DRG reimbursement, with a minimum of five years of inpatient coding experience

  • Have an understanding of Medicare, Medicaid, and commercial provider reimbursement methodologies, and possess strong data analysis skills

  • Working knowledge of computer functions and applications such as Microsoft Office (Outlook, Word, Excel) and Windows operating systems

  • Ability to write a well-reasoned review in a narrative style, with accurate spelling, grammar, punctuation, and sentence structure

  • Ability to adapt to changing priorities in order to meet Client requirements and productivity standards and deadlines

  • Ability to travel for additional training and on-site reviews on an as-needed basis

  • Since incumbents will work from their home-based offices, they must have their own access to high-speed Internet connectivity