DRG Validator – Remote Fully Remote | Full-Time We are partnering with a nationally recognized healthcare consulting organization specializing in Health Information Management and Revenue Integrity services. With a long-standing leadership team and a strong reputation in the hospital market, this firm is expanding its DRG validation team. If you are a highly experienced inpatient coding professional who thrives on accuracy, compliance, and clinical detail — this opportunity offers stability, flexibility, and meaningful impact. The Role The DRG Validator will conduct in-depth inpatient MS-DRG and APR-DRG validation reviews, ensuring accurate coding, appropriate documentation, and compliant reimbursement. You’ll work alongside a seasoned team of HIM specialists, nurses, and physicians who are deeply rooted in coding excellence and regulatory compliance. Key Responsibilities • Perform concurrent and retrospective MS-DRG and APR-DRG validation audits • Review ICD-10-CM & ICD-10-PCS code assignment • Ensure compliance with UHDDS, CMS, and federal/state regulations • Draft detailed audit rationales and physician queries • Respond to denial letters and compose supported appeal documentation • Provide coder education and written coding recommendations • Maintain 95–100% quality accuracy standards • Stay current with Coding Guidelines and AHA Coding Clinic updates ✅ Qualifications • AHIMA Certification required (CCS, RHIT, or RHIA) • 5+ years of DRG/clinical validation or claims auditing experience • Strong expertise in ICD-10-CM/PCS, MS-DRG, APR-DRG • Deep knowledge of payer reimbursement policies and regulatory compliance • Experience with 3M, TruCode, EPIC, and other encoder/EMR systems • Excellent written and verbal communication skills What’s Offered • 401(k) with match • Health, dental, vision, life insurance • Flexible schedule • Fully remote work environment • Stable, established consulting platform If you’re looking for a remote opportunity where your expertise in DRG validation truly matters — let’s connect confidentially. Message me directly for consideration. Referrals welcome.