Remote DRG Coding Specialist

MedReview Inc.; New York (NY); Remote; USD 85,000 - 95,000; Full time

Benefits offered by this job

Medical, Dental, Vision coverage

401(k) with employer match

Paid time off and holidays

FSA and commuter benefits

Professional development and ongoing培训

Job summary

MedReview Inc. is seeking an experienced DRG Reviewer to join our Payment Integrity team. This fully remote role requires expertise in inpatient coding, DRG validation, and reimbursement methodologies to support accurate claims review.

The ideal candidate will have 3+ years of acute inpatient coding experience, CCS/CIC/RHIT credentials, and strong analytical skills. EST business hours apply, and competitive compensation is offered.

Qualifications

• Current coding certification in one or more of the following: CCS, CIC, RHIT.
• Minimum of 3 years of experience in acute inpatient coding, DRG validation, coding audits, or payment integrity review.
• Strong knowledge of ICD-10-CM/PCS coding guidelines and DRG methodologies.
• Experience applying Official Coding Guidelines, AHA Coding Clinic guidance, CMS regulations, and reimbursement policies.
• Proficiency with Microsoft Office applications, including Outlook, Word, and Excel.
• Strong analytical, organizational, and critical thinking skills.
• Excellent written and verbal communication abilities.
• Ability to work independently and efficiently manage multiple priorities in a remote environment.

Responsibilities

• Review inpatient medical records and claims to validate ICD-10-CM/PCS coding accuracy and DRG assignment.
• Apply coding guidelines and CMS regulations during claim reviews.
• Identify coding discrepancies and reimbursement opportunities.
• Ensure accurate application of MS-DRG and APR-DRG methodologies.
• Evaluate claims for potential payment integrity findings and defensible determinations.

Skills

DRG validation

ICD-10-CM/PCS coding

Analytical thinking

Attention to detail

Independent work

Education

Bachelor's degree in Health Information Management or related field

Tools

Microsoft Office

Job description

MedReview Inc. is seeking an experienced DRG Reviewer to join our Payment Integrity team. This fully remote role requires expertise in inpatient coding, DRG validation, and reimbursement methodologies to support accurate claims review.

The ideal candidate will have 3+ years of acute inpatient coding experience, CCS/CIC/RHIT credentials, and strong analytical skills. EST business hours apply, and competitive compensation is offered.