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61 Drg Jobs Hiring Near You

MMC Group

DRG Auditor

San Antonio, TX · Remote

DRG Validation Auditors are charged with rendering appropriate, well-supported, and thoroughly-documented decisions, which may result in identification of improper payments (overpayments and ...

Astrana Health, Inc.

$33 - $38/hr

DRG Coder Department: HS - UM Employment Type: Full Time Location: 600 City Parkway West 10th Floor, Orange, CA 92868 Reporting To: Alice Tejeda Compensation: $33.00 - $38.00 / hour Description The ...

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 understanding of the MS-DRG and APR-DRG payment systems. The validator is responsible for auditing ...

MedReview

DRG Reviewer

Manhattan, NY · On-site +1

$85K - $90K/yr

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 ...

Astrana Health

DRG Coder

$33 - $38/hr

DRG Coder The Senior DRG Coder is responsible for reviewing inpatient medical records and accurately assigning diagnosis and procedure codes using ICD-10-CM and ICD-10-PCS to determine the ...

MedReview

DRG Reviewer

Manhattan, NY · Remote

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 ...

Machinify, Inc.

DRG ManagerRemote

$7.25/hr

Lead the DRG team by providing guidance, counsel, and development plans to ensure long-term retention and professional growth of DRG staff. Claims Review Management: Oversee the entire process of ...

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

Inpatient DRG Reviewer

Saint Louis, MO · On-site

$79K - $99K/yr

Conduct reviews on inpatient DRG claims as they compare with medical records ICD-10 Official Coding Guidelines, AHA Coding Clinic and client specific coverage policies. Conduct prompt claim review to ...

Zelis

Inpatient DRG Reviewer

Morristown, NJ · On-site

$79K - $99K/yr

Conduct reviews on inpatient DRG claims as they compare with medical records ICD-10 Official Coding Guidelines, AHA Coding Clinic and client specific coverage policies. Conduct prompt claim review to ...

EnableComp

DRG Auditor (REMOTE)

$28 - $31.75/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 ...

EnableComp

DRG Auditor (REMOTE)

OR · Remote

$28 - $31.75/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

Emory Healthcare

Inpatient DRG Coding Auditor

Atlanta, GA · On-site

$26.25 - $29.75/hr

Inpatient Drg Coding Auditor Be inspired. Be valued. Belong. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs ...

Zelis

Inpatient DRG Reviewer

Morristown, NJ

Conduct reviews on inpatient DRG claims as they compare with medical records ICD-10 Official Coding Guidelines, AHA Coding Clinic and client specific coverage policies. Conduct prompt claim review to ...

Zelis

Inpatient DRG Reviewer

Conduct reviews on inpatient DRG claims as they compare with medical records ICD-10 Official Coding Guidelines, AHA Coding Clinic and client specific coverage policies. Conduct prompt claim review to ...

EnableComp

DRG Auditor (REMOTE)

Franklin, TN · Remote

$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 ...

Zelis

Inpatient DRG Reviewer

Saint Petersburg, FL · On-site

$79K - $99K/yr

Conduct reviews on inpatient DRG claims as they compare with medical records ICD-10 Official Coding Guidelines, AHA Coding Clinic and client specific coverage policies. Conduct prompt claim review to ...

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Infographic showing various job openings at Drg in the United States as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% Physical job distribution.

DRG Auditor

MMC Group

San Antonio, TX • Remote

Full-time

Re-posted 19 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