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DRG Validator

WMCHealth

Valhalla, NYFull-time$91–114K/yrSeen 1w agoSeen in employer's feed 2 days ago

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At a glance

Compensation
$91–114K/yr
Location
Valhalla, NY
Schedule
Full-time
Work Authorization
Not specified

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Requirements

Credentials this posting asks for.

AHIMA CertificationRHIT CertificationCCS Certification

Job overview

The DRG Validator is responsible for reviewing diagnostic, procedural and DRG assignments to ensure accuracy and optimize coding. The role requires thorough knowledge of medical terminology, ICD codes and coding guidelines, strong oral and written communication skills, and proficiency with multiple EMR systems and the 3M Encoder. It also involves educating coders and medical staff on regulatory changes and assisting HIM management with reporting.

Skills & qualifications

RequiredNice to have

Skills

Medical TerminologyICD CodingCoding GuidelinesOral CommunicationWritten CommunicationEMR Systems3M Encoder

Qualifications

Bachelor's in Health Related FieldAHIMA CertificationRHIT CertificationCCS Certification2-3 Years Acute Care Experience5 Years Inpatient Experience

Benefits

Medical Insurance
Dental Insurance
Vision Insurance
401(k) Match
Paid Time Off
Tuition Assistance

Full job description

DRG Validator

Company: NorthEast Provider Solutions Inc.

City/State: Valhalla, NY

Category: Clerical/Administrative Support

Department: Health Info Mgmt-WMC Health

Union: No

Position: Full Time

Hours: 80

Shift: Day

Req #: 48666

Posted Date: Sep 29, 2026

Hiring Range: $90,979-$114,361

Apply Now

External Applicant link (https://pm.healthcaresource.com/cs/wmc1/#/preApply/34326) Internal Applicant link

Job Details:

Job Summary:

The DRG Validator will be responsible for coding reviews for the purpose of coding and DRG optimization. Must have thorough knowledge of medical terminology, ICD codes and coding guidelines. Strong oral and written communications skills is required and be proficient in working with multiple computer applications and EMR systems.

Responsibilities:

  • Review diagnostic, procedural and DRG assignments for validity and accuracy.

  • Communication discrepancies back to responsible coder for correction.

  • Educates coders on regulatory changes, trends form chart reviews, problemtic areas, high-risk and other problems identified during reviews.

  • Provides education to medical staff as necessary.

  • Contacts physicians or departmental clinical staff to resolve discrepancies or clarify information.

  • Queries physicians for clarification of documentation, if necessary.

  • Abstracts information from medical records to compile reports and statistical information.

  • Enters data, including diagnosis, procedures, admission, and discharge dates.

  • Validates discharge disposition.

  • Provides information to HIM management staff to assist in preparation of monthly reports of coder discrenpecies.

  • Keeps abreast of regulatory changes affecting coding.

  • Reviews denials from insurance companies and drafts appeals.

Qualifications/Requirements:

Experience:

Minimum of 2-3 years related experience in acute car environment; must be proficient with multiple EMR systems, 3M Encoder and have a minimum of 5 years’ experience specializing in inpatient.

Education:

Bachelor’s degree in a health related field, required. Or the equivalent combination of Experience and Education maybe substituted for degree requirement

Licenses / Certifications:

AHIMA, RHIT OR (CCS) credential, required.

About Us:

NorthEast Provider Solutions Inc.

Benefits:

We offer a comprehensive compensation and benefits package that includes:

  • Health Insurance

  • Dental

  • Vision

  • Retirement Savings Plan

  • Flexible Savings Account

  • Paid Time Off

  • Holidays

  • Tuition Reimbursement

Apply Now

External Applicant link (https://pm.healthcaresource.com/cs/wmc1/#/preApply/34326) Internal Applicant link

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