DRG Validation Coding Auditor (Healthcare Revenue Cycle)

Location: Remote within the United States; travel to and work onsite at client, temporary, or corporate offices may be required as business needs require.

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

Company

hirify.global provides technology-enabled revenue cycle management and outsourcing solutions for hospitals, health systems, and affiliated physician groups.

What you will do

• Perform documentation and coding audits for acute inpatient services, including DRG validation and clinical reviews.
• Verify that diagnoses, procedures, clinical indicators, medical records, and assigned DRGs accurately support the services provided.
• Identify coding errors, compliance concerns, overpayments, underpayments, recovery opportunities, and documentation or query opportunities.
• Write clear audit recommendations and provide feedback and education to acute inpatient coders in collaboration with CDI specialists.
• Use encoder tools, proprietary systems, claims data, and workflow processes to complete accurate and timely audit determinations.
• Maintain audit productivity and quality standards while monitoring changes to coding regulations and reimbursement policies.

Requirements

• 5+ years of coding experience, including 3+ years of facility coding audit experience such as DRG or APC validation.
• Bachelor’s degree or equivalent experience.
• Current professional certification: CPC, CCS, RHIA, or RHIT; CCS is preferred.
• Knowledge of DRG payment systems, acute inpatient coding, ICD-10-CM/PCS Official Coding Guidelines, AHA Coding Clinics, medical and surgical terminology, and HIPAA regulations.
• Experience with multiple EMR systems, encoders, and Microsoft Office; ability to communicate effectively in English.
• Ability to travel to and work onsite at client, temporary, or corporate office locations when business needs require.

Nice to have

• CCS certification.
• Openness to using AI and emerging technology to improve processes and patient and 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 quarterly or annual incentive programs.
• Culture focused on collaboration, innovation, work-life flexibility, growth, and purpose.