Remote DRG Validation Auditor – Inpatient Coding Expert

Second Wave Delivery Systems, LLC; Las Vegas (NV); On-site; USD 90,000 - 130,000; Full time

Benefits offered by this job

Health insurance

Vision insurance

Life insurance

Paid time off

Job summary

Secondwave seeks a DRG Validation Auditor to partner with a Medical Director in inpatient documentation reviews. You will validate diagnoses and procedures, update coding for compliant reimbursement, and ensure data integrity across client systems.

Ideal candidates have inpatient coding experience (3+ years), MS-DRG/APR-DRG knowledge, and AHIMA/AAPC credentials. This remote role supports HIPAA-compliant workflows and ongoing training.

Qualifications

• Active coding certification in AHIMA or AAPC (RHIA, RHIT, CCS, CPC, CIC)
• Strong knowledge of MS-DRG and APR-DRG reimbursement methodologies
• Expert understanding of ICD-10-CM/PCS coding guidelines and auditing principles

Responsibilities

• Conduct pre-bill reviews with physicians to confirm accurate diagnosis and procedure coding for inpatient encounters
• Utilize client systems to track coding changes and capture audit data
• Investigate and resolve coding compliance issues and client denials
• Maintain high accuracy and productivity while adhering to coding recommendations
• Communicate with physicians and CDI teams regarding documentation and compliance requirements
• Provide input on process improvements to enhance operational efficiency and financial accuracy
• Deliver education and training sessions on coding best practices and regulatory updates
• Stay current with coding changes and HIPAA regulations
• Ensure confidentiality of patient records and HIPAA compliance

Skills

MS-DRG

APR-DRG

ICD-10-CM/PCS

EMR systems

HIPAA compliance

Communication

Education

AHIMA/AAPC certification

Associate’s degree in Health Information Management

High School Diploma or GED

Tools

EPIC

Job description

Secondwave seeks a DRG Validation Auditor to partner with a Medical Director in inpatient documentation reviews. You will validate diagnoses and procedures, update coding for compliant reimbursement, and ensure data integrity across client systems.

Ideal candidates have inpatient coding experience (3+ years), MS-DRG/APR-DRG knowledge, and AHIMA/AAPC credentials. This remote role supports HIPAA-compliant workflows and ongoing training.