Remote DRG Auditor: Clinical Validation & Coding

Y-Axis; Northern (KY); Hybrid; USD 86,000 - 105,000; Full time

Benefits offered by this job

Competitive hourly compensation

Discretionary performance bonus

Comprehensive benefits

401(k) retirement plan

Paid family leave

Generous PTO

Fully remote work

Impactful healthcare audits

Job summary

Y-Axis is seeking an Auditor Clinical Validation DRG to perform in-depth inpatient claim audits, applying DRG/APR-DRG, ICD-10 coding, and medical necessity guidelines. This fully remote role requires strong clinical judgment, detail-oriented review, and proficiency with Excel and MS Teams to document findings and support payer compliance.

The ideal candidate has 5+ years in healthcare auditing or coding, with CMS guidelines knowledge and the ability to work independently in a remote setting,

Qualifications

• Strong clinical and coding expertise in healthcare auditing and claims validation.
• Experience with DRG/APR-DRG and ICD-9/10 coding.
• Ability to work independently in a remote, compliance-focused setting.

Responsibilities

• Perform detailed inpatient claim audits to validate DRG/APR-DRG assignments and coding compliance.
• Identify recovery opportunities and improve audit tools/workflows.
• Maintain productivity with high accuracy and audit standards.
• Document findings and prepare audit correspondence.

Skills

Clinical Validation

DRG Auditing

ICD-10 Coding

Medical Necessity Review

Claims Validation

Revenue Integrity

Analytical Thinking

Clinical Judgment

Medical Documentation

Compliance Auditing

Microsoft Excel

Education

Associate or bachelor’s degree in Nursing (active, unrestricted license)

Health Information Management (RHIA/RHIT)

Equivalent experience with high school diploma/GED

Tools

Microsoft Excel

Microsoft Teams

Access

Job description

Y-Axis is seeking an Auditor Clinical Validation DRG to perform in-depth inpatient claim audits, applying DRG/APR-DRG, ICD-10 coding, and medical necessity guidelines. This fully remote role requires strong clinical judgment, detail-oriented review, and proficiency with Excel and MS Teams to document findings and support payer compliance.

The ideal candidate has 5+ years in healthcare auditing or coding, with CMS guidelines knowledge and the ability to work independently in a remote setting,