Senior Remote DRG Clinical Validation Auditor
EXL
EXL is seeking a Quality Analyst to oversee and perform clinical CVA audits ensuring accuracy in inpatient DRG coding. The role involves reviewing audits for consistency, coaching clinical DRG auditors, and driving quality improvements across processes. The position requires a current RN license and 5+ years in clinical validation audits, with strong auditing, communication, and problem-solving skills. This remote opportunity offers exposure to a broad healthcare analytics environment and #J-18808-Ljbffr
$55 per hour
...Clinical Documentation Consultant (CDI) DRG Validation / AuditorImmediate need for a talented Clinical Documentation Consultant (CDI) DRG Validation / Auditor. This is a 06 months contract opportunity with long... ...potential and is located in US(Remote). Please review the job...Remote workContract workLocal areaImmediate start- EXL is seeking a qualified Clinical Validation Auditor to review inpatient records, validate DRG codes, and help prevent improper payments in a fully remote role based in the U.S. As a Registered Nurse with 5+ years in acute care, you’ll apply clinical and coding knowledge...Remote job
- ...EXL is seeking a Senior Clinical QA Analyst – DRG Auditing for a remote US-based role. You will supervise CVA audits, mentor auditors, and apply clinical judgment to ensure inpatient DRG accuracy. Strong DRG expertise and RN licensure are required. The role offers remote...Remote workSenior
$60.1k - $98.7k
...getting the details right? Join EXL as a Clinical Validation Auditor and help ensure medical claims are... ...and fairly. This is a fully remote position where you’ll use your clinical... ...review medical records, validate billed DRG codes, and help identify overpayments....Remote workFull time$86.56k - $129.84k
...location(s) will not be considered for employment, unless accommodation is granted as required by law. The Patient Safety DRG Clinical Validation Auditor is responsible for auditing inpatient medical records to ensure clinical documentation supports the conditions and...SuggestedFull timeWork experience placementWork at officeLocal area$95k
...Overview This DRG Validation Auditor role is focused on our Cross Claim Clinical Reviews (CCCR). Auditors in this role will be doing DRG Validation for... ...applications received or close immediately if a qualified candidate is selected. #LI-Remote #LI-JB1 #senior...Remote workHourly payFull timeReliefWork at officeImmediate startShift workNight shiftWeekend workAfternoon shift- EXL is seeking a Clinical Validation Auditor to review inpatient medical records, apply clinical judgment, and ensure accurate DRG code assignments. This fully remote role is based in the United States. You will assess medical documentation for coding accuracy, identify...Remote job
$85k - $95k
Clinical DRG Auditor - Remote Date: Apr 10, 2026 Location: Any city, TX, US, 99999 Work Mode: Virtual (Exception only) We are seeking a talented... ...DRG Auditor who is responsible for performing DRG validation (clinical/coding) reviews of medical records and/or other...Remote jobFull timeContract workFlexible hours$35 - $63 per hour
...Growing together.In this position as a Clinical DRG RN auditor, you will apply your expert knowledge... ...and Optum proprietary tools, you will validate ICD-10 diagnosis and procedure codes,... ...timeAbility to work independently in a remote environment and deliver exceptional resultsDemonstrate...Remote workHourly payMinimum wageFull timeTemporary workWork experience placementWork at officeLocal area- ...Optum is seeking a Clinical DRG RN auditor who will validate ICD-10-CM/PCS codes and DRG assignments for inpatient claims. You will write clear rationales... ...to accurate reimbursements.The role supports remote work from anywhere in the U.S. and requires strong coding...Remote work
$68.7k - $123.7k
...Senior Clinical Coding Auditor & Trainer-RemoteNew York, New York, United StatesAbout the JobThe Senior... ...Auditor & Trainer position is primarily remote with a small travel expectation on an... ...Skills:Inpatient Coding Experience (valid/current CPC, CIC, or CCS Certification...Remote workSeniorFull timePart timeWork at officeFlexible hours- Guidehealth seeks a Clinical Compliance Auditor II to ensure our clinical operations and delegated services... .... You will audit, monitor, and validate compliance with UM and PHM plans while... ...strengthen our compliance framework in a remote, agile environment with opportunities...Remote jobSenior
- ...Healthcare Coding & Consulting Services (HCCS) seeks experienced IP Auditors for full-time or part-time, fully remote roles. Candidates should have DRG validation, inpatient auditing, and complex inpatient coding experience within a Level II Trauma Center or higher. Active...Remote workFull timePart time
- ...Everest Clinical Research in Canada is seeking a Senior QA Auditor to ensure regulatory compliance across audits and SOPs. You will lead investigations, report... ...experience in clinical research. This role offers remote work from home in Canada with potential on-site visits...Remote workSeniorWork from home
- ...EXL is seeking a remote Quality Analyst to supervise the Clinical CVA auditing process, ensuring accuracy... ...role includes mentoring auditors, applying clinical judgment to DRG reviews, and driving quality... ...licensure and 5+ years of clinical validation audit experience, with...Remote work
- ...PSI, HCC and Quality Indicator validation. Uses knowledge of coding and... ...and ICD-PCS codes as well as DRG assignment.Essential... ...guidelines as supported by the clinical documentation in the record.... ...denials. Participates in on site, remote and/or external training workshops...Remote workSeniorWork at officeLocal area
- ...Lifetime Benefit Solutions, Inc. is seeking a Payment Integrity DRG Coding & Clinical Validation Analyst for detailed review of medical records and... ...background in ICD-10 coding and experience in claims auditing. Remote work may be available depending on the role. #J-18808-...Remote work
- ...Elevance Health is seeking a DRG Clinical Validation Lead to drive medically appropriate, high-quality care by evaluating inpatient and outpatient services against medical policy and benefits. This remote role requires strong clinical judgment and experience in managed...Remote work
- ...Pyramid Consulting, Inc. has an immediate opening for a DRG Validation & Clinical Documentation Specialist on a 06+ months contract, remote in the United States. The role focuses on gathering and documenting operational requirements and ensuring healthcare regulatory compliance...Remote workContract workImmediate start
- Guidehealth, a data-powered healthcare company, seeks a Clinical Compliance Auditor II to ensure adherence to UM/PHM plans and regulatory standards... ..., mentor staff, and help refine audit tools within a remote-friendly, collaborative team. The role requires RN licensure...Remote jobSenior
$55.1k - $99k
...Job Overview Clinical Coding Auditor & Trainer – Remote, NY, US. The position is primarily remote with a small... ...equivalent experience ~4+ years of DRG and/or Medical Record Audit experience... ...in a hospital setting ~ Valid/Current CPC or CIC Certification, or...Remote workPermanent employmentFull time$55.1k - $99k
...Overview We are seeking a Clinical Coding Auditor & Trainer to lead DRG and medical record auditing and deliver... ...hospital setting. Preferred Valid/current CPC or CIC Certification (AAPC... ...care. Notes Primarily remote position with limited travel (New York...Remote work- ...is seeking a Director of the Pre-bill DRG Validation Program to own strategy, operations, quality... ..., turnaround, and denial prevention. Remote role with 15-25% travel. Requires RN/MD... ...coding credentials; strong leadership, clinical documentation, and payer rule expertise...Remote job
$30.46 - $45.69 per hour
...Billing Compliance, Senior Auditor Reporting to the Manager... ...with administrative and clinical leadership. Position... ...(Evanston, IL and remote) Full Time/Part Time:... ...Medicare Manuals, and DRG/APC/RBRVS/other relevant... ...incorporating data mining, validation techniques, and...Remote workSeniorHourly payFull timeContract workPart timeFor contractorsMonday to Friday- ...Date: 2026-11-30 Position Title: Diagnosis Related Group Clinical Validation Auditor Job Description: Diagnosis Related Group Clinical... ...an accommodation is granted as required by law. The DRG Clinical Validation Auditor is responsible for auditing inpatient...Full timeTemporary workLocal area1 day per week
- ...auditing programs for Diagnosis Related Group (DRG) and Medical Record Audit programs. Location: Primarily remote with biannual travel to New York required, applicant... ...development. Analyze training needs for clinical and coding staff. Develop or select...Remote workSenior
- ...Fort Worth, TX is seeking a DRG Quality Control/Clinical Auditor. The Diagnostic Related... ...responsible for performing DRG validation (clinical/coding) reviews... ...rules. This is a remote position. ESSENTIAL FUNCTIONS... ...leveled roles (I, II, III, Senior, Lead, etc.) new hires may...Remote workMinimum wageFull timeWork at officeLocal areaFlexible hours
- ...then read the following job specs carefully before applying. is seeking a fully remote Skilled Nursing Facility auditor. You will apply extensive clinical knowledge to validate billed charges, perform coding validation, assess payment accuracy, and ensure...Remote workSenior
$45.67 per hour
Auditor Clinical Validation Outpatient Specialty Clinical Overview This auditing role will focus on Coding & Clinical Chart Validation for our Outpatient... ...with Outpatient (APC, PNPP), Pharmacy and/or Inpatient DRG claims. Draws on advanced coding expertise and industry...Hourly payContract workWork at officeImmediate start$97.76k - $116.48k
...Overview The Sr. Auditor, Quality Assurance position is responsible... ...Performs clinical quality assurance review of daily clinical validation reviews. The quality auditor... ...immediately if a qualified candidate is selected. #LI-Remote#LI-JJ1#senior...Remote workSeniorHourly payWork at officeImmediate startFlexible hours
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