Senior Inpatient DRG Auditors and Validators

Senior Inpatient DRG Auditors and Validators

We are growing our team and hiring experienced, certified Senior Inpatient DRG Auditors & Validators to ensure accurate MSDRG/APRDRG assignment, elevate documentation quality, and strengthen revenue integrity across our U.S. hospital partners. In this role, you will validate DRG groupings, identify documentation gaps, mitigate audit risk, and collaborate closely with CDI teams to support compliant, defensible outcomes. We are looking for experts with deep inpatient coding knowledge, strong clinical reasoning, and a proven ability to deliver high-quality audit results. Proficiency with the SMART tool is highly preferred.

Minimum Experience:

• 7 to 10 years of Inpatient Coding experience
• 5+ years of Inpatient Facility coding audit experience
• 2+ years DRG auditing or validation experience (pre-bill or retrospective).
• Experience with payer audits, denials, and appeals is highly preferred.
• Proficiency with EMRs, encoder/groupers, and audit platforms.

Responsibilities:

• Conduct comprehensive DRG audits (pre-bill and retrospective) for MSDRG and APRDRG cases
• Validate ICD-10-CM/PCS coding, sequencing, POA indicators, and DRG logic
• Audit coded records using the SMART tool to ensure accuracy and compliance
• Identify documentation gaps and collaborate with providers and CDI teams
• Research and resolve complex or unusual coding scenarios
• Communicate clearly with clinical personnel regarding documentation requirements
• Read and interpret medical records with precision and clinical insight

Minimum Requirements:

• Education: Science Graduate or Postgraduate. RN or MD clinical background preferred
• Credentials: Current AHIMA/AAPC certification(s) required
• Communication: Outstanding verbal and written English proficiency
• Work Location: Must be ready to work from the office