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Keywords: Medical Coding Reviewer (DRG), Location: USA

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Medical Coding Reviewer (DRG)

CANDIDATE WILL HAVE DRG CODING EXPERIENCE*** Position Purpose: Perform clinical/coding medical claim review to ensure... compliance with coding practices through a comprehensive review and analysis of medical claims, medical records, claims history...

Company: Centene
Location: USA
Posted Date: 01 Nov 2025
Salary: $26.5 - 47.59 per hour

DRG (Coding) Reviewer/Auditor

direction of the DRG Operations Department leaders, the DRG Reviewer will conduct reviews of inpatient claims for both coding... Technician (RHIT) College level courses in medical terminology, anatomy, pathophysiology, pharmacology, and medical coding...

Company: MedReview
Location: New York City, NY
Posted Date: 18 Oct 2025
Salary: $85000 - 90000 per year

DRG Clinical Registered Nurse Reviewer Manager - ( Must be Certified Professional Coder )

DRG Registered Nurse Reviewer Manager - ( Must be Certified Professional Coder - CPC) REMOTE $110 K - $120K DOE... in Microsoft Office Suite EDUCATION & EXPERIENCE: Minimum of 3-5 years of inpatient/DRG coding experience in a group health...

Location: Fort Worth, TX
Posted Date: 11 Oct 2025
Salary: $110000 - 120000 per year

Coding Quality Reviewer Specialist

Coding Quality Reviewer Specialist (Inpatient MS-DRG) Compensation: ~$40-$45/hr (midpoint $42.28/hr, based... Quality Review team ensures the accuracy and integrity of medical coding across multiple facilitiesdriving both operational...

Posted Date: 05 Nov 2025

Medical Director, DRG Audit & AI Innovation

. About the Role We are seeking a board-certified physician with strong inpatient coding and DRG audit expertise... to join our team as Medical Director, DRG Audit & AI Innovation. This position combines the rigor of traditional DRG medical director...

Company: Machinify
Location: USA
Posted Date: 18 Oct 2025

Medical Reviewer III (Medicaid)

MEDICAL REVIEWER III Conducts medical record audits to determine the medical necessity and/or appropriateness... Conducts in-depth claims analysis utilizing extensive knowledge of medical terminology, ICD-9-CM, ICD-10-CM, CPT-4, APR-DRG...

Location: USA
Posted Date: 01 Nov 2025

Medical Reviewer III (Medicaid)

: MEDICAL REVIEWER III Conducts medical record audits to determine the medical necessity and/or appropriateness of medical... in-depth claims analysis utilizing extensive knowledge of medical terminology, ICD-9-CM, ICD-10-CM, CPT-4, APR-DRG, and HCPCS...

Company: Empower AI Inc.
Location: Reston, VA
Posted Date: 01 Nov 2025

Special Investigations Unit Medical Reviewer

Special Investigations Unit Medical Reviewer (SIU Medical Reviewer) performs reviews of medical records and healthcare claims..., interpret, analyze, and make determinations concerning use of CDT, CPT, ICD, DRG, REV and HCPCS coding as it relates...

Posted Date: 09 Oct 2025
Salary: $71572.8 per year

Inpatient Coding Auditor

: Under the general supervision of the Coding Quality Manager, the Data Quality Reviewer is responsible for validating the coding... quality reviews on coded records to validate ICD-10, ICD-10-PCS, MS-DRG, APR-DRGs, and overall coding accuracy retrospectively...

Company: AdventHealth
Location: Maitland, FL
Posted Date: 30 Aug 2025

Clinical Documentation Integrity Specialist - Second Level Reviewer

documentation, or CDI second level review or inpatient coding quality review and/or DRG validation with a strong understanding... Coding Guidelines, Coding Clinic and federal updates to the DRG system Ability to conduct meaningful conversations...

Location: Washington DC
Posted Date: 25 Sep 2025
Salary: $98000 - 163000 per year

Clinical Documentation Integrity (CDI) Specialist - 2nd Level Reviewer

Coding Department and the Clinical Documentation Specialist to reconcile discrepancies in code and/or DRG assignment..., or CDI second level review or inpatient coding quality review and/or DRG validation with a strong understanding of disease...

Location: San Antonio, TX
Posted Date: 17 Sep 2025
Salary: $80000 - 133000 per year

CDI Specialist RN

Collaborates with physician, physician extender, nurse, case manager/utilization reviewer and Medical Records coder to identify...CDI Full Time Day Shift 8-5 M-F Consistently named best hospital, Lexington Medical Center dedicates itself...

Posted Date: 27 Sep 2025

CDI Specialist RN

Essential Functions Collaborates with physician, physician extender, nurse, case manager/utilization reviewer and Medical...CDI Full Time Day Shift 8/5 Consistently named best hospital, Lexington Medical Center dedicates itself...

Posted Date: 27 Sep 2025

Clinical Documentation Improvement RN

in an acute care setting. Critical Care or Medical/Surgical preferred AND 3-5 years experience with inpatient coding and DRG.... Collaborates with physician, physician extender, nurse, case manager/utilization reviewer and Medical Records coder to identify...

Posted Date: 07 Nov 2025

Clinical Documentation Improvement RN

in an acute care setting. Critical Care or Medical/Surgical preferred AND 3-5 years experience with inpatient coding and DRG.... Collaborates with physician, physician extender, nurse, case manager/utilization reviewer and Medical Records coder to identify...

Location: Aiken, SC
Posted Date: 07 Nov 2025

Director | New Product R&D

, billing guidelines, and payer policy. Strong grasp of coding and regulatory standards: ICD-10-CM/PCS, CPT/HCPCS, DRG/APC..., coding, and policy rigor with Machinify's product strategy and business goals. Help establish governance for policy...

Company: Machinify
Location: Palo Alto, CA
Posted Date: 05 Nov 2025

Lead Coder Inpatient- (10k Sign-On Bonus Available)

), and DRG (Diagnosis-Related Group) assignment. Reviewing Coder Questions: Reviews coding-related questions to ensure... with all stakeholders once the process is complete. Coding Query Reviewer: Oversees the query review process for both internal and external...

Location: Atlanta, GA
Posted Date: 06 Oct 2025

DOCUMENTATION SPEC-SOC SERVICE

queries and perform second level reviews Identify DRG mismatches and collaborate with Coding team on reconciling Provide... for CDI and Coding teams. Provide feedback and educational growth opportunities to the CDI team Conduct audits of CDI...

Posted Date: 28 Sep 2025

Clinical Documentation Specialist II

Experience Four (4) Adult medical/surgical/critical care/ER/PACU nursing coding or related field Clinical documentation... with ability to interact with providers and remain tactful. General knowledge of IPPS, ICD10 Coding, MS-DRG/APR-DRG and HCPCS...

Posted Date: 10 Sep 2025

Inpatient Coder 1

to the appropriate patient's encounter. While reviewing the record for coding purposes, serves as a quality reviewer... and experience to code In-patient medical records using ICD-9 and/or ICD-10 code set. Ensures all accounts are coded correctly...

Location: Miami, FL
Posted Date: 04 Sep 2025