Job description
Position Summary:
At MedReview, our mission is to bring accuracy, accountability and clinical excellence to healthcare. As such, we are a leading authority in payment integrity solutions including DRG Validation, Cost Outlier and Readmission reviews.We are seeking a registered nurse with extensive experience in both inpatient coding and clinical validation to work within our coding department.
This individual will Lead and support a team of clinical reviewers in the accurate validation of Diagnosis-Related Groups (DRGs) to ensure proper claim adjudication, compliance, and reimbursement accuracy.
Candidate should be highly motivated, with strong clinical and coding background. This individual must have excellent communication skills and an analytical mindset to achieve and maintain high-level performance in a fast-paced environment.
This is a fulltime position (40 hours per week) Monday – Friday. You’ll enjoy the flexibility to telecommute from anywhere within the United States. Training will be conducted virtually from your home.
If you are interested in this role with MedReview, please let us know. Here is what we are searching for:
Responsibilities:
- Lead and mentor a team of clinical DRG validators to ensure high-quality, consistent chart reviews.
- Conduct DRG validation reviews to ensure appropriate coding, sequencing, and documentation.
- Monitor performance metrics, review quality audits, and provide ongoing feedback and training.
- Collaborate with coding, compliance, and audit teams to address discrepancies and improve documentation practices.
- Serve as a subject matter expert on DRG guidelines, payer-specific requirements, and clinical documentation standards.
- Assist with onboarding, training, and performance development of new and existing team members.
- Stay current with validation updates and coding changes to ensure team alignment.
Qualifications:
- Registered Nurse (RN) license of MD required.
- Minimum 5 years clinical experience, with at least 3 years in DRG clinical validation.
- Strong knowledge of coding systems and CMS guidelines.
- Leadership experience or prior team lead/supervisory role preferred.
- Certified Coding Specialist (CCS) or Clinical Documentation Improvement certification (e.g., CCDS, CDIP) a plus.
Benefits and perks include:
- Healthcare that fits your needs - We offer excellent medical, dental, and vision plan options that provide coverage to employees and dependents.
- 401(k) with Employer Match - Join the team and we will invest in your future
- Generous Paid Time Off - Accrued PTO starting day one, plus additional days off when you’re not feeling well, to observe holidays.
- Wellness - We care about your well-being. From Commuter Benefits to FSAs, we’ve got you covered.
- Learning & Development - Through continued education/mentorship on the job and our investment in LinkedIn Learning, we’re focused on your growth as a working professional.
Salary Rate: $100,000 – 105,000/Annually.
