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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 (Coding) Reviewer/Auditor

Manhattan, NY · Remote

Payment integrity DRG validation is a plus. * Adherence to the Official Coding and Reporting ... Remote Work Requirements: * High speed internet (100 Mbps per person recommended) with secured WIFI.

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

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 ...

Zelis

Inpatient DRG Sr. Reviewer

Boston, MA · 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

Morristown, NJ · 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

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

Saint Petersburg, FL · 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 ...

Med Review Inc

Physician Reviewer

Manhattan, NY · Remote

... DRG Clinical Physician Reviewer to join our growing clinical review team. This is a fully remote opportunity for a physician with a strong background in utilization review and clinical validation who ...

MedReview

Physician Reviewer

Manhattan, NY · On-site +1

... DRG Clinical Physician Reviewer to join our growing clinical review team. This is a fully remote opportunity for a physician with a strong background in utilization review and clinical validation who ...

MedReview

Physician Reviewer

Manhattan, NY · Remote

... DRG Clinical Physician Reviewer to join our growing clinical review team. This is a fully remote opportunity for a physician with a strong background in utilization review and clinical validation who ...

TEEMA Group

$80K - $90K/yr

Perform DRG validation and retrospective medical claims reviews * Analyze inpatient and outpatient ... Remote (must reside in an approved state) Full-time position * Independent home office work ...

TEEMA Group

Sr. Inpatient Clinical Coder

Yuma, AZ · Remote

$80K - $90K/yr

Perform DRG validation and retrospective medical claims reviews * Analyze inpatient and outpatient ... Remote (must reside in an approved state) Full-time position * Independent home office work ...

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How much do remote drg validation jobs pay per hour?

As of Jun 10, 2026, the average hourly pay for remote 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 are some common challenges faced by professionals in remote DRG validation, and how can they be managed?

Remote DRG (Diagnosis-Related Group) validation specialists often encounter challenges such as limited access to on-site medical records, ensuring data security, and maintaining clear communication with hospital staff. To manage these, professionals use secure remote access systems, adhere to strict HIPAA guidelines, and establish regular virtual meetings with clinical teams. Staying organized, leveraging reliable coding software, and participating in ongoing education are also key strategies for overcoming obstacles and maintaining high accuracy in DRG validation.

What is remote DRG validation?

Remote DRG (Diagnosis-Related Group) validation is the process of reviewing and verifying the accuracy of DRG assignments in patient medical records from a remote location. This typically involves examining clinical documentation and coding to ensure that the assigned DRGs reflect the patient's diagnoses and treatments, which impacts hospital reimbursement and compliance. Remote DRG validators use secure digital systems to access records, allowing them to perform their work without being physically present at the healthcare facility. Accurate DRG validation helps prevent billing errors, reduce audit risks, and supports proper compensation for healthcare providers.

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

To thrive as a Remote DRG Validator, you need a strong background in medical coding, clinical documentation improvement, and thorough knowledge of DRG (Diagnosis-Related Group) methodologies, typically supported by credentials such as RHIA, RHIT, or CCS. Proficiency with coding software, electronic health records (EHRs), and DRG validation tools is essential. Attention to detail, analytical thinking, and effective communication are important soft skills for accurately reviewing records and collaborating with healthcare teams. These skills ensure accurate reimbursement, regulatory compliance, and improved healthcare data quality.
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Remote Drg Validation jobs near you
DRG Auditor

DRG Auditor

MMC Group

San Antonio, TX • Remote

Full-time

Posted 20 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