Remote RN Clinical Validation Auditor

Jobgether; United States; Remote; USD 60,000 - 99,000; Full time

Benefits offered by this job

Fully remote work

Work-life flexibility

Professional growth

Training and development

Collaborative environment

Healthcare benefits

Travel up to 10%

Job summary

Jobgether is partnering with a healthcare partner to fill a Clinical Validation Auditor role based in the United States. The fully remote position focuses on ensuring DRG codes are supported by clinical documentation, using clinical judgment and coding validation knowledge to identify discrepancies and potential overpayments.

The candidate will review inpatient records, document findings, and stay current with DRG requirements. Travel up to 10% may be required for occasional client engagements.

Qualifications

• Active RN license is required.
• Minimum 5 years of acute care experience, preferably in a hospital setting.
• Experience in DRG auditing or clinical coding validation is strongly preferred.
• Certifications such as CCS, RHIA, or RHIT are advantageous.
• Knowledge of readmission reviews (PPR) is a plus.
• Proficient in medical documentation review and coding/billing accuracy.

Responsibilities

• Review inpatient records to determine DRG code support by clinical documentation.
• Identify documentation discrepancies and potential overpayments.
• Document audit findings with evidence-based rationale.
• Utilize 3M and Webstrat tools to support reviews; training may be provided.
• Work independently while meeting productivity, accuracy, and quality targets.
• Stay current with DRG requirements and coding guidelines.
• Collaborate with team and participate in client onsite engagements as needed.

Skills

Analytical problem solving

Excellent communication

Attention to detail

MS Office (Excel, Word, OneNote)

Education

Certified Coding Specialist (CCS)

RHIA

RHIT

Tools

3M

Webstrat

Job description

Jobgether is partnering with a healthcare partner to fill a Clinical Validation Auditor role based in the United States. The fully remote position focuses on ensuring DRG codes are supported by clinical documentation, using clinical judgment and coding validation knowledge to identify discrepancies and potential overpayments.

The candidate will review inpatient records, document findings, and stay current with DRG requirements. Travel up to 10% may be required for occasional client engagements.