RN Nurse Auditor - Telecommute in IN or

RN, DRG Coder / Clinical Auditor
Must be a Registered Nurse with experience
Remote | Full-Time | Healthcare | Clinical Documentation & Coding
We’re seeking a detail-oriented DRG Coder/Clinical Auditor to perform DRG validation reviews of medical records and documentation. This role ensures accurate coding and clinical support for DRG assignments, helping improve billing accuracy, reimbursement, and compliance. You’ll work independently to review records, validate coding, and communicate findings clearly and professionally.
Chart Review & Validation Review medical records to validate DRG assignments and ensure clinical documentation supports coding decisions.
Physician Documentation Review Confirm that physician notes and clinical indicators support assigned DRGs.
Audit & Compliance Conduct audits to verify coding accuracy, enhance reimbursement, and identify cost-saving opportunities.
Coding Expertise Apply ICD-10-CM and PCS coding guidelines, payer rules, and regulatory standards (Medicare, Medicaid, CMS).
Communication & Reporting Clearly document findings and communicate results in a professional and concise manner.
Other Duties Support additional documentation and coding-related tasks as assigned.
Licensure : RN
Minimum 1 year of recent DRG auditing experience in a hospital or health plan setting.
Inpatient ICD-10 coding experience required.
National coding certification through AHIMA (preferred) or AAPC.
Familiarity with Coding Clinic citations and Official Coding Guidelines.
Strong understanding of Medicare/CMS documentation requirements.
Proficient in Microsoft Office Suite.

Salary is based on location, experience, qualifications, and internal equity. Headquartered in Central Florida, Pivotal Placement Services is a full-service national workforce solutions firm that specializes in placing healthcare professionals—from staff to leadership—with both clinical and non-clinical employers. Our comprehensive and customer-focused workforce solutions include Direct Placement and Managed Service Provider (MSP) / Vendor Managed Services (VMS) engagements nationwide.