Remote DRG Validation Auditor - Coding & Compliance

Second Wave Delivery Systems, LLC; Las Vegas (NV); On-site; USD 85,000 - 110,000; Full time

Benefits offered by this job

Health insurance

Vision insurance

Life insurance

Paid time off

Job summary

Second Wave Delivery Systems, LLC invites applications for a DRG Validation Auditor to partner with a Medical Director in inpatient coding reviews. You will validate diagnoses and procedure codes, ensure HIPAA compliance, and support proper reimbursement through DRG methodologies.

The role requires strong analytical skills, MS-DRG/APR-DRG knowledge, EPIC experience, and the ability to work remotely or on-site. Collaboration with physicians and CDI teams is essential for data integrity.

Qualifications

• Minimum 3 years of inpatient hospital coding experience
• Minimum 2 years in DRG validation and compliance review
• Strong knowledge of MS-DRG and APR-DRG reimbursement methodologies
• Active coding certification from AHIMA or AAPC (RHIA, RHIT, CCS, CPC, CIC)

Responsibilities

• Conduct detailed pre-bill reviews with physicians to confirm accurate inpatient coding
• Utilize client systems to track coding changes and capture audit data
• Investigate and resolve coding compliance issues and denials
• Maintain high accuracy and productivity while meeting coding recommendations
• Communicate with physicians and CDI teams regarding documentation and compliance
• Provide input on process improvements to enhance efficiency and financial accuracy
• Deliver training on coding best practices and regulatory updates
• Stay current with coding changes and HIPAA regulations
• Ensure confidentiality of patient records and HIPAA adherence
• Perform additional coding tasks as needed

Skills

ICD-10-CM/PCS knowledge

Auditing principles

Communication skills

MS-DRG/APR-DRG knowledge

EPIC proficiency

Microsoft Office

Remote/work adaptability

Education

Associate’s degree in Health Information Management or related field

High School Diploma or GED

AHIMA/AAPC certification (RHIA/RHIT/CCS/CPC/CIC)

Tools

EPIC

Coding software

Job description

Second Wave Delivery Systems, LLC invites applications for a DRG Validation Auditor to partner with a Medical Director in inpatient coding reviews. You will validate diagnoses and procedure codes, ensure HIPAA compliance, and support proper reimbursement through DRG methodologies.

The role requires strong analytical skills, MS-DRG/APR-DRG knowledge, EPIC experience, and the ability to work remotely or on-site. Collaboration with physicians and CDI teams is essential for data integrity.