Refactor Talent · 2 days ago
DRG Reviewer Nashville
Nashville Metro
Full-time
Onsite
Senior Level
$90K/yr - $105K/yr
5+ years expRefactor Talent is engaged by a fast-growing healthcare AI company seeking an experienced DRG Reviewer to join their Nashville team. The role focuses on ensuring accurate reimbursement and compliant DRG assignments through a blend of coding expertise and advanced technology.
E-LearningHuman ResourcesRecruitingStaffing Agency
Hiring Manager
Jen Beatty
Responsibilities
Conducting MS-DRG and APR-DRG audits for provider organizations
Reviewing inpatient medical records and applying ICD-10-CM/PCS coding guidelines
Validating DRG assignments and documenting defensible, compliant recommendations
Utilizing proprietary AI-supported auditing tools to streamline review workflows
Partnering with audit teams on large-scale engagements and complex claim denials
Participating in provider meetings and exit interviews to present findings
Staying current on Official Coding Guidelines, AHA Coding Clinic updates, and regulatory changes
Qualification
Required
Active national certification (RHIA, RHIT, CCS, or equivalent)
5+ years of inpatient coding experience (IPPS environment)
2+ years conducting DRG validation or inpatient claims auditing
Deep knowledge of DRG structure, coding conventions, and clinical documentation
Ability to operate effectively in a high-volume, fast-paced setting
Strong communication skills and sound clinical judgment
Preferred
Experience with coding software and major EMR systems
Background in Clinical Documentation Improvement (CDI)
Benefits
Medical, dental, and vision coverage
401(k) with company match
PTO, holidays, and volunteer days
Tuition reimbursement
Company-paid life insurance, short-term disability, and parental leave
Flexible spending accounts
Company
Refactor Talent
Refactor Talent is a staffing and recruiting firm that provides enhancement courses, and learning and development programs.
11-50 employees
Funding
Current Stage
Early StageLeadership Team
Richard Myers
Co-Founder
Abigail Petersen
Client Partner
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