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Agent guide: [/agents.md](https://www.wearedevelopers.com/agents.md). --- # Remote DRG Validator - **Company:** MEDIX - **Location:** United States (Remote available) - **Experience:** Expert - **Salary:** $90,000.0 - $120,000.0 - **Contract:** Permanent contract - **Skills:** Microsoft Word, Microsoft Excel, Microsoft Outlook, Computer Programming, Microsoft Office, Microsoft PowerPoint, Microsoft SharePoint, Electronic Medical Records - **Published:** June 23, 2026 - **Apply:** https://www.indeed.com/viewjob?jk=24d4159d11875314 ## About the Role Do you have experience in Video conferencing systems operation?, * AHIMA credential required: CCS, RHIT, or RHIA. * Minimum of 5 years of experience in clinical validation, DRG auditing, coding quality review, claims auditing, recovery auditing, or related healthcare revenue cycle functions. * Extensive experience with ICD-10-CM, ICD-10-PCS, MS-DRG, and APR-DRG methodologies. * Strong understanding of medical terminology, anatomy and physiology, reimbursement systems, CPT coding, modifiers, and payer-specific requirements. * Expert knowledge of Official Coding Guidelines, AHA Coding Clinic publications, CMS regulations, and healthcare compliance standards. * Proficiency with Microsoft Office applications (Outlook, Word, Excel, PowerPoint) and healthcare auditing/coding platforms including 3M, TruCode, Microsoft Teams, and SharePoint., * Excellent written and verbal communication skills with the ability to effectively educate and influence clinical and coding staff. * Strong analytical, critical-thinking, and problem-solving abilities with exceptional attention to detail. * Self-motivated and able to work independently while managing multiple priorities and deadlines. * Demonstrated ability to meet or exceed productivity, quality, and turnaround-time expectations. ## Description * Conduct concurrent and retrospective clinical validation audits to ensure accurate MS-DRG and APR-DRG assignment in accordance with UHDDS requirements, Medicare guidelines, and applicable federal and state regulations. * Review and validate ICD-10-CM diagnosis coding and ICD-10-PCS procedure coding for accuracy and compliance. * Utilize electronic medical records, coding encoders, and audit software (e.g., 3M, Epic, TruCode) to support clinical validation and coding review activities. * Develop detailed audit findings and clear, evidence-based rationales to support review outcomes. * Prepare and issue physician queries to clarify clinical documentation and improve coding accuracy. * Provide coding education and feedback to coding professionals using Official Coding Guidelines, AHA Coding Clinic references, and industry best practices. * Evaluate coding and DRG-related denials and prepare comprehensive appeal responses for payers, RACs, PROs, and third-party auditors. * Recommend appropriate coding, DRG assignment, severity of illness (SOI), and documentation improvements. * Maintain current knowledge of coding regulations, reimbursement methodologies, and industry updates. * Consistently achieve established productivity, quality, and accuracy benchmarks. * Collaborate with physicians, Clinical Documentation Integrity (CDI) teams, coders, and other healthcare professionals to promote compliant documentation and coding practices. ## Related Videos - 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