Inpatient Coding Associate (Flexible)

DRG Validation Auditor — Independent Contractor (1099)

Company: Revu Healthcare
Position Type: Independent Contractor (1099) — Project-Based / On-Call Roster
Work Location: Remote
Active Project Commitment for This Posting: Minimum 40 hours per week while assigned
Project Productivity Requirement: Minimum 10 completed accounts per day while actively assigned to this project

About Revu Healthcare

Revu Healthcare is a healthcare consulting firm specializing in compliance, revenue integrity, coding validation, and audit review services. Our team includes certified coders, consultants, nurses, and physicians dedicated to helping healthcare organizations maintain regulatory compliance, coding accuracy, and payment integrity.

We partner with hospitals, health systems, payors, and consulting organizations to deliver high-quality inpatient coding audits, DRG validation reviews, clinical validation, and compliance support.

Position Overview

Revu Healthcare is seeking experienced DRG Validation Auditors to join our independent contractor talent roster and support inpatient coding and payment integrity audit projects as client needs arise.

This is a 1099 independent contractor position. Contractors are engaged on a project-by-project basis, and acceptance onto Revu Healthcare's roster does not guarantee immediate, continuous, or year-round assignments.

For the project opportunity associated with this posting, selected contractors must be able to commit a minimum of 40 hours per week while actively assigned and maintain a productivity expectation of a minimum of 10 completed accounts per day. Productivity must be achieved while maintaining all applicable quality, accuracy, documentation, and deadline requirements.

Project requirements may vary across Revu Healthcare engagements. The 40-hour weekly commitment and 10-account daily productivity requirement stated in this posting apply specifically to this project opportunity and should not be interpreted as universal requirements for every Revu Healthcare project.

Candidates should be comfortable with project-based assignments and the possibility of periods in which no matching project work is available between engagements.

Responsibilities

When assigned to the project associated with this posting, the DRG Validation Auditor will:

• Conduct thorough reviews of inpatient healthcare claims and medical records to identify discrepancies between physician documentation, the clinical picture presented in the record, billed codes, and the resulting DRG.
• Validate DRG assignment using applicable ICD-10-CM and ICD-10-PCS coding conventions, instructions, guidelines, policies, and Coding Clinic guidance.
• Review medical record documentation for coding accuracy, clinical support, and compliance.
• Use recognized industry references to support audit findings, including ICD-10-CM and ICD-10-PCS Official Guidelines for Coding and Reporting, AHA Coding Clinic guidance, AHIMA Standards of Ethical Coding, and applicable policies and regulations.
• Write complete, clear, and accurate audit rationales supported by specific medical record documentation and appropriate coding, clinical, regulatory, or policy references.
• Identify coding, clinical validation, and DRG discrepancies and clearly communicate the rationale supporting each determination.
• Maintain current knowledge of coding, clinical, regulatory, reimbursement, and other industry changes relevant to inpatient auditing.
• Apply critical thinking and independent research to complex coding and clinical scenarios.
• Follow all client-specific audit tools, workflows, documentation requirements, scorecards, and quality standards.
• Participate in required project training, kick-off calls, calibration sessions, and periodic team meetings as applicable.
• Maintain HIPAA compliance and safeguard all PHI/PII in accordance with applicable requirements.
• Submit completed work and required time entries in accordance with Revu Healthcare and project requirements.
• Meet or exceed all applicable project performance and quality standards.

Responsibilities Between Active Assignments

Contractors who wish to remain available for future Revu Healthcare project opportunities are expected to:

• Maintain all required professional certifications and credentials in active status.
• Maintain access to applicable client systems by completing required periodic logins when requested.
• Respond to Revu Healthcare regarding availability for upcoming assignments.
• Complete applicable project-specific onboarding, training, system access, or compliance requirements before beginning an assignment.

Required Qualifications

Applicants must meet all of the following minimum qualifications to be considered for this opportunity:

• Minimum of an associate degree.
• Current RHIT or RHIA credential through AHIMA.
• Current inpatient coding credential: CCS or CIC.
• Current clinical validation credential: CDIP, CCDS, or CDEI.
• Minimum 3 years of ICD-10 inpatient coding experience.
• Minimum 1 year of clinical experience in a healthcare facility setting.
• Minimum 3 years of auditing experience or demonstrated equivalent.
• Minimum 1 year of auditing experience in a payor setting.
• Minimum 1 year of inpatient rehabilitation coding/auditing experience.
• Minimum 1 year of inpatient psychiatric coding/auditing experience.
• Comprehensive understanding of ICD-10-CM inpatient coding guidelines, AHA Coding Clinic guidance, and DRG grouping mechanics.
• Strong, current clinical knowledge base.
• Familiarity with Clinical Documentation Integrity (CDI) practices.
• Awareness of and adherence to HIPAA and applicable requirements regarding the safeguarding of PHI/PII.
• Ability to conduct independent research using credible sources.
• Demonstrated working knowledge of Microsoft Word, Excel, and PowerPoint.
• Ability to apply strong critical-thinking skills to medical record reviews.
• Ability to work independently, manage workload, meet deadlines, and adapt to shifting priorities.
• Willingness to learn and adapt to new auditing skills across a variety of coding and clinical scenarios.
• Excellent written and verbal communication skills.
• Ability to work effectively in a fast-paced, changing project environment.
• Secure and private home workspace with reliable high-speed internet.
• Ability to commit a minimum of 40 hours per week while actively assigned to the project associated with this posting.
• Ability to meet this project's productivity expectation of a minimum of 10 completed accounts per day while actively assigned, while meeting all applicable quality, accuracy, documentation, and deadline requirements.
• Successful completion of any Revu Healthcare and/or client-required assessment, onboarding, or training.

Preferred Qualifications

• Bachelor's degree.
• AHIMA Inpatient Coding Auditing Microcredential and/or AAPC Certified Professional Medical Auditor (CPMA).
• 5+ years of inpatient ICD-10 coding and auditing experience.
• 5+ years of relevant clinical validation and medical necessity auditing experience.
• Additional AHIMA, AAPC, or ACDIS coding, auditing, or CDI credentials.
• Advanced experience with inpatient rehabilitation coding/auditing.
• Advanced experience with inpatient psychiatric coding/auditing.
• Experience with payment integrity and payor-side DRG validation.
• Prior consulting or independent contractor audit experience.
• Experience working with multiple EMR systems, including Epic or Cerner.
• Experience with audit scorecards, quality assurance, and client-specific validation processes.
• Availability to work Eastern Time Zone hours when needed for project meetings, training, or client collaboration.

Independent Contractor & Project Assignment Information

• This opportunity is offered exclusively as an independent contractor (1099) engagement through Revu Healthcare.
• Contractors may be added to Revu Healthcare's qualified talent roster and contacted as project opportunities become available based on their qualifications, experience, availability, and applicable client requirements.
• There is no guarantee of immediate placement, continuous assignments, a minimum number of projects, or ongoing work between assignments.
• For the specific project opportunity associated with this posting, contractors who accept an assignment must be prepared to commit a minimum of 40 hours per week while actively assigned, unless Revu Healthcare communicates a different requirement for the engagement.
• The minimum 10-account-per-day productivity expectation is specific to the project associated with this posting and is not a universal productivity standard for all Revu Healthcare projects. Contractors assigned to this project are expected to complete a minimum of 10 accounts per day while meeting all applicable quality, accuracy, documentation, and deadline requirements.
• Productivity expectations for other Revu Healthcare projects may differ based on project scope, review type, complexity, client requirements, and other applicable factors. Project-specific expectations will be communicated when an assignment is offered.
• Revu Healthcare contractors are generally permitted to support multiple Revu Healthcare clients and/or projects concurrently, provided all accepted project commitments, deadlines, productivity expectations, and deliverables are consistently met and the quality of work remains in accordance with Revu Healthcare standards.
• Contractors are responsible for managing accepted project commitments appropriately and promptly communicating any capacity concerns or potential conflicts that could affect deadlines, productivity, quality, or deliverables.
• Project volume, duration, and assignment availability depend on client demand and may fluctuate.
• Contractors may experience periods between assignments during which no project work is available.
• This is a 1099 independent contractor engagement and does not include employee benefits or overtime compensation.
• Contractors are responsible for maintaining their own equipment, secure workspace, reliable high-speed internet connection, and other resources necessary to perform remote work unless otherwise specified.
• All work must be performed in compliance with HIPAA, applicable privacy and security requirements, and client confidentiality requirements.
• Project-specific training, meetings, availability expectations, workflows, productivity requirements, and deadlines will be communicated as applicable to each engagement.