At MedReview, the DRG Reviewer supports payment integrity initiatives by performing inpatient claim reviews to validate coding accuracy and appropriate DRG assignment.
This role works under the direction of the DRG Operations leadership team and helps identify cases requiring clinical review to support coded diagnoses. The position is fully remote, with availability required during Eastern Standard Time business hours.
Requirements & Qualifications
Must hold at least one active coding credential:
- Certified Coding Specialist (CCS)
- Certified Inpatient Coder (CIC)
- Registered Health Information Technician (RHIT)
Additional qualifications:
- College-level coursework in medical terminology, anatomy, pathophysiology, pharmacology, and medical coding
- 3+ years of experience in MS-DRG and APR-DRG validation in acute care inpatient coding and auditing
- Knowledge of the Official Coding and Reporting Guidelines, AHA Coding Clinic determinations, and CMS/regulatory requirements
- Proficiency with Outlook, Word, Excel, and related applications
- Strong written and verbal communication skills
- Ability to work independently, multitask, and prioritize workload
- Must maintain credential status through continuing education
- Must have high-speed internet, secured Wi-Fi, and a dedicated workspace for remote work
- Ability to sit and use a computer keyboard for extended periods
Benefits & Perks
Benefits and perks include:
- Medical, dental, and vision coverage for employees and dependents
- 401(k) with employer match
- PTO starting on day one, plus additional sick days and holidays
- Commuter benefits and flexible spending accounts (FSAs)
- Learning and development support, including continued education, mentorship, and LinkedIn Learning
Location
N/A
Employment Type
Full-time
Experience Level
Senior
Salary Range
$85,000 - $90,000
Remote work allowed
Yes
Posted
1 month ago
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