IP DRG Auditor/Validator

Company Description RSD Human Resource Management Consultancy is a professional services firm specializing in talent acquisition, HR advisory, and workforce solutions for clients across healthcare and other key sectors. The consultancy focuses on matching qualified professionals with roles that align with their expertise and career goals, while supporting organizations in building strong, compliant teams. RSD emphasizes ethical practices, confidentiality, and long-term partnerships with both clients and candidates. The firm is committed to continuous improvement and staying current with industry standards and regulatory requirements to better serve all stakeholders.
Role Description The IP DRG Auditor/Validator is a full-time remote role responsible for auditing and validating inpatient coding and Diagnosis-Related Group (DRG) assignments to ensure accuracy, compliance, and optimal reimbursement. Day-to-day responsibilities include reviewing medical records, verifying ICD and procedure codes, confirming DRG groupings, and identifying documentation gaps or inconsistencies. The role involves preparing clear audit findings, providing feedback to coding and clinical teams, and recommending corrective actions or education to improve coding quality. The IP DRG Auditor/Validator will also monitor regulatory changes, payer guidelines, and coding standards, and collaborate with internal and client stakeholders to support audit readiness and reduce compliance risks.
Qualifications

• Candidates should possess strong inpatient coding and DRG validation skills, including expertise in ICD-10-CM/PCS and DRG grouping methodologies.
• Candidates should possess skills in clinical documentation review, medical terminology, and understanding of disease processes and inpatient workflows.
• Candidates should possess skills in healthcare compliance, reimbursement guidelines, and familiarity with regulatory and payer requirements.
• Candidates should possess skills in data analysis, attention to detail, and the ability to interpret audit results and performance metrics.
• Candidates should possess effective written and verbal communication skills, including the ability to provide clear feedback and education to coding and clinical teams.
• Relevant professional certifications (e.g., CCS, CIC, RHIA, RHIT, or equivalent coding credentials) are highly beneficial.
• Experience in inpatient coding, DRG auditing, or revenue integrity within a hospital or consulting environment is preferred.
• Ability to work independently in a remote setting, manage multiple audits, and meet deadlines while maintaining high quality standards.