Senior DRG Clinical Validation Auditor (Remote)
Elevance Health
- Remote job
Elevance Health is seeking a Patient Safety DRG Clinical Validation Auditor to audit inpatient medical records and ensure documentation supports DRGs billed and reimbursed. The role requires extensive ICD-10 coding expertise and experience in DRG-related auditing. The candidate will analyze claims, generate detailed audit findings, and suggest process improvements. A current RN license is required, with a minimum of 10 years in audits or clinical documentation improvement. #J-18808-Ljbffr Elevance Health
$45 - $50 per hour
...Clinical Documentation Consultant (CDI) DRG Validation / Auditor Immediate need for a talented Clinical Documentation Consultant (CDI) DRG Validation / Auditor... ...opportunity with long-term potential and is located in US(Remote). Pay Range: $45 - $50/hour. Traveler benefits...Remote workContract workLocal areaImmediate start$35 - $62.5 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,... ...Ability to work independently in a remote environment and deliver exceptional results...Remote workHourly payDaily paidMinimum wageFull timeTemporary workPart timeWork experience placementWork at officeLocal areaRelocation package- ExlService Holdings, Inc. is seeking a Clinical Validation Auditor to review inpatient records and validate billed DRG codes. You will apply clinical judgment to ensure accuracy... ...and fairness in claims coding while working remotely. Ideal candidates are licensed nurses with...Remote job
- ...getting the details right? Join EXL as a Clinical Validation Auditor and help ensure medical claims are... ...accurately and fairly. This is a fully remote position where you’ll use your clinical... ...medical records, validate billed DRG codes, and help identify overpayments....Remote work
$90k - $105k
...We are seeking a talented individual for a Clinical DRG Auditor who is responsible for performing DRG validation (clinical/coding) reviews of medical records and... ...etc. What you should expect in this role Remote within the U.S. May be required to work extended...Remote workFull timeContract workFlexible hours$45.67 per hour
Auditor Clinical Validation Outpatient Specialty Clinical Job Locations US-Remote ID 2026-18743 Category Audit - Healthcare Position Type... ...), Pharmacy and/or Inpatient DRG claims. Draws on advanced... ...is selected. #LI-Remote #LI-JJ1 #senior #J-18808-Ljbffr CotivitiRemote workHourly payFull timeContract workWork at officeImmediate start$90k - $104.84k
...RN, DRG Coder / Clinical Auditor Must be a Registered Nurse with experience Remote | Full-Time | Healthcare | Clinical Documentation & Coding About the Role... ...DRG Coder/Clinical Auditor to perform DRG validation reviews of medical records and documentation...Remote workFull timeWork at office$85k - $90k
...partners closely with Clinical Auditors, Quality Analysts, and... ...guidelines, clinical validation requirements, and audit... ...quality by translating DRG validation... ...in a cross-functional, remote environment. Strong organizational... ...is assigned a senior-level professional as...Remote work$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...Full timeTemporary workWork experience placementWork at officeLocal area1 day per week$86.56k - $129.84k
...Patient Safety DRG Clinical Validation Auditor Location: This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration...Full timeWork at officeLocal area- TEEMA Solutions Group is seeking a Senior Clinical Coder for a fully remote opportunity focused on inpatient facility coding and DRG validation. You will support clinical operations teams in complex medical claims reviews and ensure coding accuracy. The ideal candidate...Remote jobSeniorPermanent employment
- Oscar Health Insurance is seeking a Senior Analyst, SIU Clinical Investigator to detect and audit aberrant billing patterns in claims and clinical... ...files for potential recovery or referrals. This is a remote role with NYC/Tempe office options. #J-18808-Ljbffr Oscar...Remote jobSeniorWork at office
$34.23 - $61.15 per hour
About This Role As a Clinical DRG RN Auditor at UnitedHealth Group, you will leverage your expertise in MS-DRG and APR-DRG coding methodologies to audit inpatient claims, ensuring accuracy and identifying overpayments. This role is ideal for those with strong analytical...Hourly payFull timeTemporary workRelocation packageDay shift- ...and compliance, the part-time PRN DRG Revenue Integrity Auditor will perform validation and quality audits on inpatient... ...federal regulations while working remotely. Key responsibilities: Conduct DRG... ...experience as a DRG Auditor or Clinical Documentation Specialist in an acute...Remote workPart timeRelief
$55.1k - $99k
...Clinical Coding Auditor & Trainer This is a remote position. Compensation: $55,100.00 - $99,000.00 per year Must... ...PA, MD, APRN, DO, or MBBS license Valid/Current CPC or CIC Certification,... ...equivalent experience ~4+ years of DRG and/or Medical Record Audit...Remote work$68.57k - $104.84k
...DRG Quality Control/Clinical AuditorCERIS in Fort Worth, TX is seeking... ...Control/Clinical Auditor. The Diagnostic Related... ...for performing DRG validation (clinical/coding) reviews... ...rules.This is a remote position.Essential... ...roles (I, II, III, Senior, Lead, etc.) new hires...Remote workMinimum wageFull timeLocal areaFlexible hours$90k - $115k
A healthcare intelligence company is seeking a DRG Reviewer to conduct payment validation reviews. The ideal candidate will possess a nursing degree or... ...Responsibilities include auditing medical records, providing clinical support, and ensuring compliance with regulations. The...Remote jobFlexible hours- ...-22Humana Inc. is seeking a Senior Medical Coding Outpatient Auditor to lead coding-focused audit activities, validate coding accuracy, and ensure... ...guidelines, and collaborating with clinical and analytics teams to improve audit strategies. Remote work with occasional travel...Remote workSenior
- ...DRG Validation Auditor Last year our HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a DRG Validation... ..., coding guidelines, Company policies and procedures, and clinical/medical resources to assure coding knowledge and skills...Temporary workWork from homeFlexible hours
- Job Description Insight Global is seeking a DRG Validation Auditor for one of our clients to sit 100% remote. This person should have an extensive background in either facility-based nursing, clinical documentation, and/or inpatient coding and has a high level of understanding...Remote work
$30.46 - $45.69 per hour
.... Billing Compliance, Senior Auditor Reporting to the Manager... ...administrative and clinical leadership. Position Highlights... ...(Evanston, IL and remote) Full Time/Part Time:... ...Medicare Manuals, and DRG/APC/RBRVS/other... ...incorporating data mining, validation techniques, and...Remote workSeniorHourly payFull timeContract workPart timeFor contractorsMonday to Friday$70.14k - $107.25k
...The Diagnostic Related Groups (DRG) Clinical Auditor will be responsible for performing DRG validation (clinical/coding) reviews of... ...For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be... ...workplace, and complies with ADA regulations as applicable. #LI-Remote...Remote workMinimum wageFull timeWork at officeLocal areaFlexible hours- ...years. Position Summary The DRG Auditor is responsible for reviewing... ...inpatient claims to identify and validate missed reimbursement... ...medical record documentation, clinical coding guidelines, and DRG reimbursement... ...is primarily office-based or remote, depending on company policy,...Remote jobFlexible hours
$55.1k - $99k
About the job Clinical Coding Auditor & Trainer We are looking for a Clinical Coding... ...position is primarily remote with a small travel expectation... ...Diagnosis Related Group (DRG) and Medical Record Audit Programs... ...License / Certification Valid/Current CPC or CIC Certification...Remote workFull timePart timeWork at officeFlexible hours- ...Clinical Validation Nurse At MedReview, our mission is to bring accuracy, accountability, and... ...payment integrity solutions including DRG Validation, Cost Outlier and Readmission... ...multiple applications at the same time Remote Work Requirements: High speed...Remote workFull timeMonday to Friday
- CERIS, a division of CorVel, seeks a DRG Clinical Auditor to perform DRG validation reviews, determine correct coding, and document findings. The role requires ICD-10-CM/PCS proficiency, clinical knowledge, and familiarity with medical necessity rules. The position emphasizes...
- ...healthcare financial experience. The Senior Content Ideation Specialist... ...for Itemized Bill Review and DRG Validation within the Expert Claim... ...ICD-10, AHA, AMA, CPT, CMS and clinical research sources. The role... ...projects; in-office and hybrid/remote options #J-18808-Ljbffr...Remote workSeniorWork at office
- ...2026-08-20Elevance Health is seeking a DRG Coding Auditor to review inpatient records and ensure... ...accurate DRG assignments. You will conduct clinical reviews, leverage ICD-10 coding... ...expertise, and document audit findings. Hybrid/remote work with occasional in-person training...Remote work
- ...Elevance HealthPosted: 2026-08-19Elevance Health is seeking a DRG Coding Auditor to ensure accuracy in MS-DRG and APR-DRG classifications... ...inpatient records, spanning all lines of business. The role blends clinical review with coding expertise to audit and generate high-...Remote work
- ...Healthcare Compliance Auditor Senior IThe Healthcare Compliance Auditor... ...activities and collaborates with clinical, operational, revenue cycle,... ..., with a combination of remote work and on-site attendance... ...for improvement.Monitors and validates the implementation of...Remote workSeniorFull timeWork experience placementMonday to Friday
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Senior DRG Clinical Validation Auditor (Remote). Be the first to apply!
- lease auditor Indianapolis, IN
- field auditor Indianapolis, IN
- medical claims auditor Indianapolis, IN
- data auditor Indianapolis, IN
- auditor Indianapolis, IN
- medical records auditor Indianapolis, IN
- inventory auditor Indianapolis, IN
- safety auditor Indianapolis, IN
- remote nurse auditor Indianapolis, IN
- security auditor Indianapolis, IN


