Remote DRG Reviewer — Inpatient Coding & Reimbursement

MedReview; United States; 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 support

Job summary

MedReview seeks an experienced DRG Reviewer to join our Payment Integrity team. This fully remote role analyzes inpatient records and claims to validate coding accuracy, ensure proper DRG assignment, and identify opportunities for reimbursement improvements.

Candidates must be available to work EST business hours. The ideal candidate has 3+ years in acute inpatient coding, CCS/CIC/RHIT certification, strong ICD-10-CM/PCS knowledge, and excellent analytical and communication skills.

Qualifications

• Current coding certification (CCS/CIC/RHIT)
• Minimum 3 years in acute inpatient coding, DRG validation, audits, or payment integrity review
• Strong knowledge of ICD-10-CM/PCS and DRG methodologies
• Experience applying coding guidelines, CMS regulations, and reimbursement policies
• Proficiency with Microsoft Office applications
• Excellent written and verbal communication; ability to work independently in a remote environment

Responsibilities

• Review inpatient records and claims to validate ICD-10-CM/PCS coding and DRG assignment
• Apply Official Coding Guidelines, AHA Coding Clinic guidance, CMS regulations during reviews
• Identify coding discrepancies, documentation concerns, and reimbursement opportunities
• Ensure proper MS-DRG and APR-DRG application and accuracy
• Collaborate with physician reviewers and maintain compliant, well-documented review records
• Maintain confidentiality, HIPAA compliance, and data security in all activities

Skills

CCS/CIC/RHIT

Analytical thinking

Communication

Remote work

Education

Bachelor's degree in Health Information Management or related field

Tools

Microsoft Office

Job description

MedReview seeks an experienced DRG Reviewer to join our Payment Integrity team. This fully remote role analyzes inpatient records and claims to validate coding accuracy, ensure proper DRG assignment, and identify opportunities for reimbursement improvements.

Candidates must be available to work EST business hours. The ideal candidate has 3+ years in acute inpatient coding, CCS/CIC/RHIT certification, strong ICD-10-CM/PCS knowledge, and excellent analytical and communication skills.