DRG Validator

Responsibilities

• Review inpatient medical records to validate the accuracy of assigned DRGs
• Ensure compliance with ICD-10-CM/PCS coding guidelines and CMS regulations
• Identify discrepancies in coding or documentation and recommend corrections
• Collaborate with coding teams, CDI specialists, and physicians to clarify documentation
• Conduct audits to detect undercoding, overcoding, or billing errors
• Provide feedback and education to coding staff on DRG optimization and compliance
• Maintain productivity and quality standards for case reviews

Requirements

• Certified coding credential (RHIA, RHIT, CCS)
• Strong knowledge of ICD-10-CM/PCS coding systems
• Experience with Patient Safety Indicators (PSIs) and Hospital Acquired Conditions (HACs)
• Understanding of MS-DRG/APR-DRG methodologies
• Minimum of 2-3 years’ experience in inpatient coding and auditing or DRG validation
• Proficiency in Microsoft Office, particularly Outlook and Excel
• Strong technical skills with VPNs, multi-factor authentication, and video conferencing tools

About the Company

UASI works with top hospitals and HIM experts in the industry, providing professional growth, development, and a dynamic work environment.