DRG Reviewer

MedReview Inc.

DRG Reviewer conducting reviews of inpatient claims to ensure coding accuracy at MedReview. A fully remote position requiring coding certification and 3+ years of experience.

Posted 7/8/2026full-timeRemote • 🇺🇸 United StatesMid-LevelSenior💰 $85,000 - $90,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in inpatient coding and compliance with Official Coding and Reporting Guidelines, ensuring accurate DRG assignment and billing. Proficient in medical terminology and coding standards, with a strong focus on productivity and accuracy in claim reviews.

Highest-signal resume keywords

Coding CertificationCertified Coding Specialist (CCS)Certified Inpatient Coder (CIC)Registered Health Information Technician (RHIT)MS-DRG and APR-DRG Validation Experience

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

ICD-10-CM/PCS CodingClaim ReviewDRG AssignmentPayment Integrity ValidationMedical CodingAuditingMedical TerminologyAnatomy KnowledgePathophysiology KnowledgePharmacology Knowledge

Soft Skills

Excellent Written CommunicationExcellent Verbal CommunicationOrganizational SkillsAbility to Multi-taskIndependent Work

Tools & Technologies

OutlookWordExcel

Certifications & Qualifications

Certified Coding Specialist (CCS)Certified Inpatient Coder (CIC)Registered Health Information Technician (RHIT)

Industry Keywords

Official Coding GuidelinesAHA Coding ClinicCMS ComplianceRegulatory ComplianceAcute Care Inpatient Coding

About the role

Key responsibilities & impact

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.
Must be available to work a 7.5-hour workday during Eastern Standard Time (EST) business hours.
Comply with organization policy and procedures.

Requirements

What you’ll need

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

Comp & perks

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.