DRG Validation Coding Auditor (Healthcare)

Location: Remote nationwide within the United States; candidates must reside in and be authorized to work in the United States. Travel to client, temporary, or corporate office locations may be required as business needs arise.

Salary: $69,400–$104,100 annually, based on experience.

Company

hirify.global provides technology-enabled revenue cycle management and point solutions for hospitals, health systems, and affiliated physician groups across the United States.

What you will do

• Perform acute inpatient DRG coding and clinical reviews across MS-DRG, APR-DRG, and TRICARE payment systems.
• Assess medical records to verify that coded diagnoses, procedures, clinical indicators, and assigned DRGs are supported by documentation.
• Identify coding errors, compliance concerns, overpayments, underpayments, recovery opportunities, and documentation or query opportunities.
• Write clear audit recommendations and provide education to acute inpatient coders using current ICD-10-CM/PCS guidelines and AHA Coding Clinics.
• Collaborate with CDI specialists and contribute to process improvement, audit tools, and workflow enhancements.
• Maintain audit quality and productivity standards while completing reviews accurately and on time.

Requirements

• 5+ years of coding experience, including 3+ years of facility coding audit experience such as DRG or APC validation.
• Current certification in at least one of CPC, CCS, RHIA, or RHIT; CCS is preferred.
• Bachelor’s degree or equivalent experience.
• Knowledge of reimbursement guidelines, medical and surgical terminology, HIPAA regulations, and acute inpatient coding standards.
• Experience with multiple EMR systems, encoder tools, and Microsoft Office; strong written and verbal communication skills.
• Must reside in and be authorized to work in the United States; the role may require travel and onsite work at client, temporary, or corporate locations.

Nice to have

• CCS certification.
• Openness to using AI and emerging technology to improve coding and patient or client experiences.

Culture & Benefits

• Comprehensive healthcare, time off, retirement, and well-being benefits.
• Paid professional certifications and tuition reimbursement.
• Career advancement and professional development opportunities.
• Bonus and incentive programs for employees.
• Culture focused on collaboration, growth, innovation, work-life flexibility, and continuous improvement.