Remote DRG Validation Auditor | Inpatient Coding Expert

Second Wave Delivery Systems; Las Vegas (NV); Remote; 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 is seeking a DRG Validation Auditor to partner with a Medical Director to ensure accurate DRG assignment through inpatient record reviews and coding updates in line with federal guidelines and client standards.

You will conduct pre-bill reviews with physicians, use client systems to track changes, resolve coding issues, train staff, and help maintain data integrity and compliant reimbursement while working remotely.

Qualifications

• Inpatient coding and DRG validation experience required.
• Active coding certification (AHIMA or AAPC) expected.
• Strong knowledge of MS-DRG and APR-DRG reimbursement methodologies.
• Ability to interpret complex documentation and apply compliant coding updates.

Responsibilities

• Conduct pre-bill reviews with physicians to verify accurate diagnosis and procedure coding for inpatient encounters.
• Utilize client systems to track coding changes, identify query opportunities, and capture audit data.
• Investigate and resolve coding compliance issues and denials.
• Maintain high accuracy and productivity while aligning with coding recommendations.
• Communicate with physicians and CDI teams on documentation and compliance requirements.
• Provide input on process improvements to enhance financial accuracy.
• Deliver training sessions on coding best practices and regulatory updates.
• Stay current with coding changes and HIPAA requirements.

Skills

ICD-10-CM/PCS coding

Auditing principles

Analytical thinking

Communication skills

MS Office

EPIC experience

Regulatory knowledge

Confidentiality

Remote work adaptability

Education

High School Diploma or GED

Associate’s degree in Health Information Management

Tools

EPIC

EMR systems

Job description

Second Wave Delivery Systems, LLC is seeking a DRG Validation Auditor to partner with a Medical Director to ensure accurate DRG assignment through inpatient record reviews and coding updates in line with federal guidelines and client standards.

You will conduct pre-bill reviews with physicians, use client systems to track changes, resolve coding issues, train staff, and help maintain data integrity and compliant reimbursement while working remotely.