Remote RN DRG Validation Auditor III

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

Job summary

EXL is seeking a Clinical Validation Auditor (CVA) Auditor III to verify inpatient DRG coding accuracy from medical records in a fully remote US role. You’ll apply clinical judgment, coordinate with quality teams, and document rationale for coding decisions.

Ideal candidates are RN with active license, experience in acute care, and familiarity with tools like 3M or Webstrat. Excellent attention to detail, ability to work independently, and strong communication will help you succeed in a remote

Qualifications

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

Responsibilities

• Review inpatient medical records to verify that the DRG code makes sense based on the documentation.
• Apply clinical and coding knowledge to spot inaccuracies and identify potential overpayments.
• Document your findings in clear, professional language that explains the rationale behind your review.
• Use industry tools like 3M or Webstrat to support your decisions.
• Work independently while meeting productivity and quality goals.
• Stay up to date with clinical guidelines, DRG rules, and industry trends.

Skills

Attention To Consistency

Computer Literacy

Microsoft Office

Internal Communications

Working under Pressure

Registered Nurse

Education

Registered Nurse license

Tools

3M

Webstrat

Job description

EXL is seeking a Clinical Validation Auditor (CVA) Auditor III to verify inpatient DRG coding accuracy from medical records in a fully remote US role. You’ll apply clinical judgment, coordinate with quality teams, and document rationale for coding decisions.

Ideal candidates are RN with active license, experience in acute care, and familiarity with tools like 3M or Webstrat. Excellent attention to detail, ability to work independently, and strong communication will help you succeed in a remote