EnableComp provides specialty revenue cycle management solutions for healthcare organizations, with a focus on complex claims, reimbursement optimization, and revenue integrity.
The DRG Validator/Reviewer is responsible for reviewing post-billed inpatient claims to identify and validate missed reimbursement opportunities based on diagnosis and procedure coding. Working in a specialized DRG database, this role uses ICD-10 coding expertise to analyze medical records, determine coding accuracy, and recommend reimbursement improvements. The position requires handling protected health information (PHI) with a high level of privacy, security, and professionalism.
This position is primarily office-based or remote, depending on company policy, and involves extensive computer-based record review, documentation, client reporting, and collaboration with leadership.
- Associate's or bachelor's degree in health information management or a related field required
- RHIT or RHIA credential preferred
- Certified Coding Specialist (CCS) certification required
- 2-3 years of experience in DRG validation, inpatient medical coding, or related coding review
- Strong understanding of ICD-10-CM/PCS coding guidelines, DRG reimbursement methodology, and hospital billing processes
- Ability to read and interpret clinical documentation from multiple departments, including nursing, operative, radiology, and pharmacy
- Experience in a post-bill coding environment and familiarity with DRG grouping software and billing databases
- Strong analytical, problem-solving, written, and verbal communication skills
- Proficiency with EMRs, digital platforms, and Microsoft Office applications
- Ability to manage high volumes of work, meet deadlines, and work independently in a detail-oriented environment
- Remote work opportunity depending on company policy
- Opportunity to work with a recognized healthcare revenue cycle organization
- Professional growth and development support
- Collaborative and feedback-driven work environment
Location
N/A
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
Yes
Posted
4 weeks ago