DRG Validator

About the role

The DRG Validator is responsible for reviewing inpatient medical records to ensure the accuracy and integrity of DRG assignments, clinical documentation, and coding. This role supports compliance with regulatory guidelines and optimizes appropriate reimbursement.

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 3 years’ experience in inpatient coding and auditing or DRG validation
• Strong technical skills, including experience with VPNs, multi-factor authentication, and video conferencing tools
• Proficiency in Microsoft Office, particularly Outlook (email and calendar) and Excel
• A consistent, reliable work schedule and punctual attendance

Benefits

UASI provides employees with the tools needed for professional growth and development. We also recognize that our employees are our greatest asset and in return for your talents, we offer a dynamic work environment, career-growth and development, strong leadership and top pay.