MedReview Inc. · 1 month ago
DRG (Coding) Reviewer/Auditor
United States
Full-time
Remote
Mid Level
$85K/yr - $90K/yr
3+ years expMedReview Inc. is a leading authority in payment integrity solutions, focused on ensuring accuracy and clinical excellence in healthcare. The DRG Reviewer will conduct reviews of inpatient claims for coding accuracy and perform screenings for clinical support of coded diagnoses.
Health CareMedicalNon ProfitProfessional Services
Responsibilities
Analyze and review inpatient claims following the Official Coding and Reporting Guidelines to validate the reported ICD-10-CM/PCS codes to ensure proper DRG assignment for accurate billing
Demonstrates the ability to perform a comprehensive initial review as outlined in the standard operating procedures and departmental guides
Collaborates with physician reviewers, as needed
Ability to prioritize and organize workload and complete tasks independently
Required attendance of all departmental team meetings and/or training
Work on other duties or tasks, as necessary
Report productivity daily utilizing department productivity report
Meet/exceed daily productivity expectations
Maintains 95% accuracy in claim reviews
Required to work a 7.5-hour workday within the company’s core hours
Comply with organization policy and procedures
Qualification
Required
Coding Certification required (at least one of the following is required and must be maintained as a condition of employment): Certified Coding Specialist (CCS), Certified Inpatient Coder (CIC), Registered Heath Information Technician (RHIT)
College level courses in medical terminology, anatomy, pathophysiology, pharmacology, and medical coding courses
At least 3 years' experience in MS-DRG and APR-DRG validation in acute care inpatient coding, auditing. Payment integrity DRG validation is a plus
Adherence to the Official Coding and Reporting guidelines, AHA Coding Clinic determinations, and CMS and other regulatory compliance guidelines and mandates
Requires working knowledge of applicable industry-based standards
Proficiency in Outlook, Word, Excel, and other applications
Excellent written and verbal communication skills
Maintain professional credentialed status with approved continuing education programs
Ability to work independently and can multi-task or transition to different tasks easily
Benefits
Healthcare that fits your needs - We offer excellent medical, dental, and vision plan options that provide coverage to employees and dependents.
401(k) with Employer Match - Join the team and we will invest in your future
Generous Paid Time Off - Accrued PTO starting day one, plus additional days off when you’re not feeling well, to observe holidays.
Wellness - We care about your well-being. From Commuter Benefits to FSAs we’ve got you covered.
Learning & Development - Through continued education/mentorship on the job and our investment in LinkedIn Learning, we’re focused on your growth as a working professional.
Company
MedReview Inc.
MedReview is a different type of payment integrity company.
201-500 employees
Funding
Current Stage
Growth StageLeadership Team
Spencer Young
Chief Executive Officer
Ripal Patel
Chief Financial Officer
Recent News
2025-11-20
2025-08-29
2025-07-23
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