DRG Dispute Reviewer
Machinify · United States · US
Utilization Review
Remote
Nurse
Dentist
Demand78
Career growth68
Healthcare fit64
Remote potential65
Salary band
USD 100k – 115k
5-year outlook
Specialized DRG validation, CDI, and revenue-integrity skills should remain in demand as payers and providers continue auditing reimbursement, though exact pay will vary by credentials, location, and market.
Clinical license
Not required
Applicant reach
narrow
Seniority
senior
Employment type
full-time
Date found
2026-11-08
Intelligence details
Flexible work details
- Engagement type
- Permanent
- Hours
- Full-time
- Eligible countries
- United States
- License jurisdiction
- US
- Profession fit
- Nurse, Dentist
- Rate period
- Annual
Listing via Himalayas.
Eligibility, licensing, and location restrictions can change. Always confirm details on the source posting before applying.
Why this is worth applying to
Worth applying only if you already have inpatient coding, CDI, DRG validation, or audit/appeals experience and a relevant coding credential. General clinicians without that specialized background are unlikely to be competitive.
Who should apply
RNs with inpatient CDI or coding experience, HIM professionals, certified inpatient coders, DRG validation specialists, and revenue-integrity/audit professionals with payer appeal or recovery audit exposure.
CV angle
Frame real inpatient experience around chart review, clinical validation, documentation quality, medical necessity assessment, DRG assignment, payer policy, compliance, and written audit rationales. Nurses should highlight CDI collaboration, ICD-10 exposure, coding credentials, and any appeal, audit, or reimbursement accuracy work without inventing coding experience.
Skills to highlight
- DRG validation
- MS-DRG and APR-DRG methodology
- ICD-10-CM/PCS coding
- Clinical documentation integrity
- Medical record and UB-04 review
- Payer appeals and audit support
- Compliance and HIPAA
- Written rationale and client communication
Role summary
Reviews provider appeals and original audit findings, validates MS-DRG/APR-DRG assignments using clinical and coding expertise, and prepares defensible written rationales to support payment determinations and compliance.
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