Remote Inpatient DRG Validation Auditor (CMS)

Cotiviti; United States; Remote; USD 90,000 - 100,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Disability insurance

Life insurance

401(k)

Paid family leave

9 paid holidays per year

PTO 17-27 days

Job summary

Cotiviti is seeking an Auditor DRG Validation (CMS Audits) to perform inpatient DRG coding audits, focusing on coding accuracy and appropriate treatment settings. The role supports inpatient chart validation from a coding and billing perspective.

This remote, full-time position begins on 11/9/2026. You will use Cotiviti audit tools, review medical records, and document audit conclusions. Strong knowledge of ICD-9/10CM, DRG concepts, and CMS guidelines is required.

Qualifications

• 5 to 7+ years with ICD-9/10CM, MS-DRG, AP-DRG and APR-DRG experience.
• Adherence to CMS guidelines, coding clinic determinations, and payer policies.
• Strong communication skills and proficiency with standard office tools.

Responsibilities

• Audits inpatient DRG claims using medical chart coding principles and guidelines.
• Reviews records, substantiates conclusions with clinical knowledge.
• Documents audit results and letters; identifies new claim types and recoveries.
• Uses Cotiviti audit tools to make determinations and meet productivity/quality standards.
• Completes annual performance plan duties and other assigned projects.

Skills

ICD-9/10CM, DRG concepts

MS-DRG, AP-DRG, APR-DRG knowledge

Proficiency in Word, Access, Excel, TE

Excellent written and verbal comms

Education

RHIA

RHIT

CPC

Inpatient Coding Credential - CCS/CIC/CDIP/CCDS

Health Information Management degree (RHIA/RHIT)

Tools

Word

Access

Excel

TEAMS

Job description

Cotiviti is seeking an Auditor DRG Validation (CMS Audits) to perform inpatient DRG coding audits, focusing on coding accuracy and appropriate treatment settings. The role supports inpatient chart validation from a coding and billing perspective.

This remote, full-time position begins on 11/9/2026. You will use Cotiviti audit tools, review medical records, and document audit conclusions. Strong knowledge of ICD-9/10CM, DRG concepts, and CMS guidelines is required.