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Remote Drg Validation Reviewer Jobs (NOW HIRING)

MMC Group

DRG Auditor

San Antonio, TX · Remote

... 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 ...

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 ...

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 ...

Jzanus Consulting

DRG Validator- Remote

Garden City, NY · Remote

$80K/yr

... DRG validation reviews in compliance with appropriate coding and payments adhering to Uniform ... Remote Experience: ICD coding: 5 years (Required) License/Certification:AHIMA Certification ...

EnableComp

DRG Validator/Reviewer (REMOTE)

OR · On-site +1

Certified Coding Specialist (CCS) certification required. * 2-3 years' experience in DRG validation ... remote, depending on company policy, with extensive computer and document review work. * Must be ...

EnableComp

DRG Validator/Reviewer (REMOTE)

Franklin, TN · Remote

Certified Coding Specialist (CCS) certification required. * 2-3 years' experience in DRG validation ... remote, depending on company policy, with extensive computer and document review work. * Must be ...

EnableComp

DRG Validator/Reviewer (REMOTE)

Franklin, TN · Remote

Certified Coding Specialist (CCS) certification required. * 2-3 years' experience in DRG validation ... remote, depending on company policy, with extensive computer and document review work. * Must be ...

EnableComp

DRG Validator/Reviewer (REMOTE)

Certified Coding Specialist (CCS) certification required. * 2-3 years' experience in DRG validation ... remote, depending on company policy, with extensive computer and document review work. * Must be ...

Centene

DRG Reviewer

$70K - $126K/yr

Remote Role: 4+ years experience of performing MS-DRG and APR-DRG coding required. In-patient and ... Operates with significant autonomy in supporting DRG validation reviews and appeals, interpreting ...

Med Review Inc

Physician Reviewer

... 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 ...

R1

DRG Validation Auditor I

$48K - $81K/yr

Review inpatient medical records for validation of DRG assignment * Provide detailed rationale and supporting evidence for the recommendation and findings * Utilize industry-recognized references to ...

R1

DRG Validation Auditor I

$48K - $81K/yr

Review inpatient medical records for validation of DRG assignment * Provide detailed rationale and supporting evidence for the recommendation and findings * Utilize industry-recognized references to ...

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How much do remote drg validation reviewer jobs pay per hour?

As of Sep 1, 2026, the average hourly pay for remote 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 is the difference between Remote Drg Validation Reviewer vs Remote Medical Coder?

AspectRemote Drg Validation ReviewerRemote Medical Coder
CredentialsTypically requires coding certification and knowledge of DRG systemsRequires medical coding certification (e.g., CPC, CCS)
Work EnvironmentHealthcare facilities, insurance companies, or remote healthcare teamsHospitals, clinics, or remote coding companies
Industry UsageUsed mainly in hospital billing and reimbursement validationUsed in medical billing, coding, and documentation
Search/Comparison IntentOften compared for roles involving coding and validation of diagnosesCompared for coding accuracy and documentation review roles

The Remote Drg Validation Reviewer and Remote Medical Coder roles both require coding certifications and work within healthcare settings. However, the reviewer focuses on validating DRG assignments for reimbursement, while the coder primarily translates medical documentation into codes. Both roles are essential in healthcare billing but differ in their specific responsibilities and focus areas.

More about Remote Drg Validation Reviewer jobs

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Remote Drg Validation Reviewer jobs near you
Infographic showing various Remote Drg Validation Reviewer job openings in the United States as of August 2026, with employment types broken down into 93% Full Time, 3% Part Time, and 4% Contract. Highlights an 85% Physical, 5% Hybrid, and 10% Remote job distribution, with an average salary of $108,152 per year, or $52 per hour.

DRG Auditor

MMC Group

San Antonio, TX • Remote

Full-time

Re-posted 14 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