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2h ago Curated

DRG Clinical Validation Lead

Elevance Health

Job description

The DRG Clinical Validation Lead is responsible for performing clinical validation of DRG assignments to ensure accuracy and compliance with coding guidelines. This role involves reviewing medical records, identifying discrepancies, and collaborating with coding and clinical teams to resolve issues. The position is 100% remote and requires an active RN license with a compact privilege. Minimum of 5 years of acute care nursing experience and 2 years of clinical validation or CDI experience required. BSN preferred. Salary range: $80,000–$120,000.

Key responsibilities

  • Perform clinical validation of DRG assignments
  • Review medical records for accuracy and completeness
  • Identify and resolve DRG discrepancies
  • Collaborate with coding and clinical teams
  • Ensure compliance with coding guidelines and regulations

What you bring

  • Active RN license with compact privilege
  • 5+ years acute care nursing experience
  • 2+ years clinical validation or CDI experience
  • Knowledge of DRG methodology and coding guidelines
  • Strong analytical and communication skills

Tags

100% RemoteDRG ValidationCDICompact RN

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