DRG Validation Specialist - Fully Remote

MaineHealth
parental leave
United States, Maine, Scarborough
301B U.S. 1 (Show on map)
Jun 17, 2025
Description The DRG Validation Specialist role is responsible for performing DRG Validation quality reviews for inpatient coded records to validate codes for appropriate DRG assignment. Fully Remote Working Schedule The DRG Validation Specialist job functions include: reviews codes to validate DRG assignment appeals external audits processes Cloudmed recommendations resolves DRG matches between CDI and coding answers coding questions identifies opportunities for query composition improvement/compliance identifies educational needs creates educational materials The DRG Validation Specialist requirements and preferences include: RHIA, RHIT or CCS credentialing Auditing experience Strong oral and written communication skills Critical thinking and strong organizational skills A minimum of 5 years of inpatient coding experience is preferred Required Minimum Knowledge, Skills, and Abilities (KSAs) Education: Associate's and/or Bachelor's Degree in Health Information Management or other science based degree such as Nursing required. License/Certifications: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), or Certified Coding Specialist (CCS) required. Experience: Three years of experience as an inpatient coder at a large acute care or academic teaching facility required. Additional Skills/Requirements Required: N/A Additional Skills/Requirements Preferred: Advanced coding skills and knowledge of revenue cycle, billing systems, EPIC Electronic Health Record and 3M Encoder, ICD 10 training, Computer Assisted Coding software (CAC) Additional Information With a career at any of the MaineHealth locations across Maine and New Hampshire, you'll be working with health care professionals that truly value the people around them - both within the walls of the organization and the communities that surround it. We offer benefits that support an individual's needs for today and flexibility to plan for tomorrow - programs such as paid parental leave, a flexible work policy, student loan assistance, training and education, along with well-being resources for you and your family. MaineHealth remains focused on investing in our care team and developing an inclusive environment where you can thrive and feel supported to realize your full potential. If you're looking to build a career in a place where people help one another deliver best-in-class care, apply today. If you have questions about this role, please contact Kerry A. Huckins at kerry.huckins2@mainehealth.org