Certified DRG Validator

Job Summary

To support compliance and optimize reimbursement, the remote Certified DRG Validator will review inpatient medical records for accuracy in DRG assignments, ensuring adherence to coding guidelines and regulations.

Key Responsibilities

• Review inpatient medical records to validate the accuracy of assigned DRGs
• Ensure compliance with ICD-10-CM/PCS coding guidelines and CMS regulations
• Identify discrepancies in coding or documentation and recommend corrections

Required Qualifications

• Certified coding credential (RHIA, RHIT, CCS)
• Strong knowledge of ICD-10-CM/PCS coding systems
• Understanding of MS-DRG/APR-DRG methodologies
• Minimum of 3 years' experience in inpatient coding and auditing or DRG validation
• Proficiency in Microsoft Office, particularly Outlook and Excel