Job Title: Inpatient Coding Auditor - DRG Validation Location: Remote Salary: $33.00 – $50.00 per hour Schedule: Full-time Travel: Initial onsite orientation during the first week with occasional additional travel as needed
Job Overview:
We are seeking an experienced Inpatient Coding Auditor specializing in DRG validation to review medical records and ensure the accuracy of Diagnosis Related Group assignments. This role focuses on validating inpatient coding, evaluating clinical documentation, and ensuring compliance with CMS regulations and coding guidelines.
The ideal candidate has strong inpatient coding experience, deep knowledge of DRG assignment, and the ability to analyze clinical documentation to ensure accurate coding and reimbursement.
Key Responsibilities:
Review inpatient medical records to validate accurate DRG assignment and coding compliance
Analyze patient charts to identify discrepancies in coding or clinical documentation
Ensure coding accuracy according to CMS regulations and industry coding guidelines
Conduct second-level reviews of DRGs, discharge dispositions, and Present on Admission (POA) indicators prior to billing
Collaborate with coding teams and clinical staff to resolve documentation and coding questions
Participate in coding audits and quality improvement initiatives
Research and respond to coding or documentation denials related to DRG assignments
Provide guidance and education to coding staff regarding documentation and coding best practices
Support regulatory compliance and internal audit activities
Required Qualifications:
Minimum of 5 years of inpatient coding experience
Experience with DRG validation, auditing, or coding quality review
Strong understanding of clinical documentation and coding compliance standards
Ability to work independently in a remote environment
Strong analytical and communication skills
Education:
Required Certification:Candidates must hold at least one of the following credentials:
RHIA
RHIT
CCS
CPC
CCS-P
Technical Knowledge:
Strong understanding of DRG assignment and coding guidelines
Familiarity with UB-04 billing standards and CMS regulations
Experience reviewing clinical documentation for coding accuracy
Benefits:
Competitive hourly compensation
Comprehensive medical, dental, and vision coverage
Three weeks of paid vacation
Fully remote work environment
Opportunity to work in a specialized coding and compliance role within healthcare operations
