Remote DRG Validation Specialist (Inpatient Claims)

MedReview; New York (NY); Remote; USD 85,000 - 90,000; Full time

Benefits offered by this job

Healthcare benefits

401(k) with company match

Generous PTO

Wellness programs

Learning & Development

Job summary

MedReview, a leading authority in payment integrity solutions, is seeking a DRG Reviewer to validate inpatient claims and DRG assignments while identifying cases needing clinical review. This is a fully remote role, with work hours aligned to Eastern Time.

The position requires coding credentials (CCS/CIC/RHIT), 3+ years in MS-DRG/APR-DRG validation, and strong proficiency with ICD coding guidelines. Competitive salary and benefits offered.

Qualifications

• Certification in CCS, CIC, or RHIT required and maintained.
• 3+ years of MS-DRG/APR-DRG validation in acute care coding or auditing.
• Familiarity with Official Coding and Reporting guidelines and CMS/industry standards.
• Proficiency in Outlook, Word, Excel and related applications.

Responsibilities

• Analyze and review inpatient claims to validate ICD-10-CM/PCS codes.
• Ensure proper DRG assignment and flags cases needing clinical review.
• Collaborate with physician reviewers as needed.
• Prioritize workload and complete tasks independently.
• Attend departmental meetings and trainings.
• Perform other duties as assigned.

Skills

MS-DRG validation experience

Independent work style

Excellent written and verbal comms

Education

Certified Coding Specialist (CCS)

Certified Inpatient Coder (CIC)

Registered Health Information Technician (RHIT)

Tools

Outlook

Word

Excel

Job description

MedReview, a leading authority in payment integrity solutions, is seeking a DRG Reviewer to validate inpatient claims and DRG assignments while identifying cases needing clinical review. This is a fully remote role, with work hours aligned to Eastern Time.

The position requires coding credentials (CCS/CIC/RHIT), 3+ years in MS-DRG/APR-DRG validation, and strong proficiency with ICD coding guidelines. Competitive salary and benefits offered.