This job has expired
This position was posted on September 24, 2025 and is likely no longer accepting applications. We've kept it here for historical reference. Check out the similar jobs below!
Job Overview
Location
Franklin, TN
Job Type
Full-time
Category
Data Analyst
Date Posted
September 24, 2025
Full Job Description
đź“‹ Description
- • Own the final line of defense for hospital reimbursement as a DRG Validator Reviewer, remotely safeguarding millions in earned revenue for health systems nationwide. Every inpatient chart you touch has already been billed—your forensic review of ICD-10-CM/PCS codes uncovers hidden DRG shifts, missed CC/MCC captures, and procedure mismatches that directly increase yield and reduce write-offs.
- • Dive deep into proprietary DRG analytics software that pre-screens 100 % of a client’s weekly inpatient census and surfaces high-value edits (dialysis, embolization, catheterization, mechanical ventilation, OR procedures). You will validate, override, or re-sequence diagnoses and procedures to arrive at the optimal DRG with the highest allowable reimbursement while remaining fully compliant with Medicare, Medicaid, and commercial payer guidelines.
- • Conduct systematic medical-record navigation—discharge summary, H&P, operative notes, radiology, pathology, pharmacy administration, and nursing flow sheets—to locate the clinical evidence required to support DRG validation. Translate complex clinical concepts into precise ICD-10 codes, then articulate findings in concise rationales that stand up to external auditor scrutiny.
- • Partner with EnableComp’s DRG leadership team to prioritize accounts by financial impact, age of bill, and client strategic goals. Maintain a personal pipeline of 40–60 cases per week, achieving ≥ 95 % accuracy and ≤ 48-hour turnaround from assignment to client-ready recommendation. Track productivity and quality metrics inside Salesforce and the E360 platform, contributing to dashboards viewed by C-suite clients.
- • Generate actionable reimbursement reports that quantify DRG weight change, geometric mean length-of-stay impact, and estimated net revenue lift. Present summaries during weekly client calls, educating hospital CFOs, HIM directors, and case-management teams on root-cause denial patterns and documentation improvement opportunities that prevent future leakage.
- • Champion continuous learning: monitor quarterly ICD-10 Cooperating Parties updates, AHA Coding Clinic guidance, and CMS 3M Grouper releases; test new edit logic in sandbox environments; share peer-to-peer lunch-and-learn sessions that elevate team proficiency and maintain EnableComp’s industry-leading 24-year reputation.
- • Protect the integrity of every patient record. Adhere to HIPAA, HITECH, and client-specific data-use agreements while working within VPN-secured, SOC-2-certified infrastructure. Report privacy events immediately and complete annual compliance training with 100 % pass rate.
- • Contribute to product evolution by logging enhancement requests, documenting false-positive edits, and beta-testing AI-driven DRG predictors. Your frontline feedback directly influences the roadmap of the E360 platform used by 500+ hospitals.
- • Embrace a culture recognized by Inc. 5000 and Black Book as #1 Specialty RCM provider—where teammates “share the same vision,” celebrate wins on Slack, and rally around core values: Empower, Serve, Grow, Have Fun, and Be Accessible.
🎯 Requirements
- • Current Certified Coding Specialist (CCS) credential required; RHIT, RHIA, or CIC preferred
- • 2–3 years of inpatient DRG validation, post-bill coding review, or clinical documentation-improvement experience with proven revenue-impact results
- • Expert command of ICD-10-CM/PCS Official Guidelines, DRG GROUPER logic, and Medicare MS-DRG reimbursement methodology
- • Demonstrated ability to interpret multi-disciplinary clinical documentation and assign/validate codes at 95 % accuracy or higher in a high-volume environment
- • Proficiency with EMRs (Epic, Cerner, Meditech), MS Excel pivot tables, and remote VPN workflow; dual-monitor home office setup capable of secure PHI handling
🏖️ Benefits
- • 100 % remote flexibility with company-provided laptop, dual monitors, and monthly internet stipend—design your own schedule within core hours
- • Competitive base salary plus quarterly performance bonus tied to validated revenue recoveries; average DRG reviewers exceed bonus target by 18 %
- • 100 % employer-paid medical, dental, and vision for employee; 75 % paid for dependents, plus HSA company match and free virtual telehealth
- • 18 PTO days year one, 10 paid holidays, and annual “Recharge Week” where entire company shuts down—no PTO required
Skills & Technologies
Remote
Degree Required
About EnableComp, LLC
EnableComp provides revenue cycle management services focused on complex claims, specifically workers’ compensation and veterans affairs reimbursements for hospitals and health systems. Founded in 2000 and headquartered in Franklin, Tennessee, the company combines proprietary software with specialized expertise to identify, file, and resolve claims that traditional billing teams often overlook. Its technology platform integrates with existing hospital information systems to recover otherwise lost revenue, increase cash flow, and reduce administrative burden for healthcare providers nationwide.
Get more remote jobs like this
Subscribe to the weekly newsletter for similar remote roles and curated hiring updates.
Newsletter
Weekly remote jobs and featured talent.
No spam. Only curated remote roles and product updates. You can unsubscribe anytime.
Similar Opportunities
❌ EXPIRED
CookUnity Inc.
Buenos Aires, Buenos Aires, Argentina; Lima, Lima Province, Peru
Full-time
Expired Apr 25, 2026
Remote
Degree Required
3 months ago
