Remote RN: Clinical Validation & DRG Coding Auditor

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

Job summary

EXL is seeking a qualified Clinical Validation Auditor to review inpatient records, validate DRG codes, and help prevent improper payments in a fully remote role based in the U.S.

As a Registered Nurse with 5+ years in acute care, you’ll apply clinical and coding knowledge using tools like 3M or Webstrat, document findings clearly, and stay current with DRG rules while meeting productivity and quality targets.

Qualifications

• RN license and active status.
• 5+ years in acute care hospital setting.
• Experience with DRG audits or coding validation.
• Certifications CCS, RHIA, or RHIT are a plus.
• Knowledge of readmission reviews (PPR) is also a plus.

Responsibilities

• Review inpatient medical records to verify DRG codes align with documentation.
• Apply clinical and coding knowledge to spot inaccuracies and identify potential overpayments.
• Document findings in clear, professional language with rationale.
• Use industry tools like 3M or Webstrat; training provided if needed.
• Work independently while meeting productivity and quality goals.
• Stay up to date with clinical guidelines, DRG rules, and industry trends.

Skills

RN licensed

Acute care experience

DRG audits

Coding validation

CCS

RHIA

RHIT

Readmission reviews

Tools

Excel

Word

OneNote

Job description

EXL is seeking a qualified Clinical Validation Auditor to review inpatient records, validate DRG codes, and help prevent improper payments in a fully remote role based in the U.S.

As a Registered Nurse with 5+ years in acute care, you’ll apply clinical and coding knowledge using tools like 3M or Webstrat, document findings clearly, and stay current with DRG rules while meeting productivity and quality targets.