DRG Validation Auditor I in United States at Jobgether

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a DRG Validation Auditor I based in the United States.

This role focuses on ensuring the accuracy and integrity of inpatient hospital billing through detailed DRG validation and clinical documentation review.
You will work within advanced healthcare systems and proprietary auditing tools to assess medical records and confirm appropriate coding assignments.
The position plays a key part in supporting compliant reimbursement practices and improving overall revenue cycle performance.
You will collaborate with clinical coding and revenue integrity teams in a highly regulated, quality-driven environment.
Your work directly contributes to both financial accuracy and improved patient record documentation standards.
This is a detail-oriented, remote-friendly role suited for experienced coding professionals seeking meaningful impact in healthcare operations.

• Review inpatient medical records to validate DRG assignments and ensure coding accuracy and compliance with regulatory standards.
• Analyze clinical documentation within EMR and proprietary systems to identify discrepancies or opportunities for correction.
• Provide clear, evidence-based rationales for all audit findings using recognized industry guidelines.
• Apply authoritative references such as ICD-10 Official Guidelines, AHIMA standards, and AHA Coding Clinics to support decisions.
• Collaborate with internal teams to support documentation improvement and revenue integrity initiatives.

• Active AHIMA credential required (RHIA, RHIT, and/or CCS).
• Minimum of 3+ years of ICD-10 coding and DRG reimbursement experience, including recent acute inpatient auditing exposure.
• Strong familiarity with multiple EMR systems such as Epic, Cerner, and Meditech.
• Solid understanding of inpatient coding guidelines, compliance standards, and documentation practices.
• Excellent analytical skills with high attention to detail and ability to interpret complex clinical records.
• Strong communication skills to clearly document audit findings and recommendations.

• Competitive annual salary range: $48,131.00 – $81,225.49 (based on experience, skills, and location).
• Eligibility for annual bonus plan with a target of 5%.
• Comprehensive healthcare benefits package including medical, dental, and vision coverage.
• Flexible work environment supporting remote or hybrid arrangements (role dependent).
• Opportunities for continuous learning, professional growth, and cross-functional collaboration.
• Inclusive workplace culture focused on innovation, patient impact, and community engagement.