DRG Validator

At Kodiak Solutions, we’re dedicated to transforming the healthcare industry through cutting-edge, technology-driven solutions. We specialize in healthcare finance, unclaimed property, risk management, and revenue cycle management, helping healthcare organizations streamline complex financial operations. Our mission is to simplify and optimize processes, so healthcare providers can focus on delivering excellent patient care.

Position Summary

The DRG Validator plays an integral role within Kodiak’s Revenue Integrity Optimization team, helping healthcare organizations improve coding accuracy, compliance, quality, and reimbursement. Working alongside an experienced, U.S.-based team, Validators perform comprehensive inpatient coding and clinical validation reviews across both MS-DRG and APR-DRG methodologies.

DRG validation at Kodiak goes beyond traditional inpatient coding review, incorporating broader clinical and quality considerations such as Hospital-Acquired Conditions (HACs), Patient Safety Indicators (PSIs), and Elixhauser measures. This expanded approach provides Validators exposure to a diverse and evolving range of coding, clinical quality, and revenue integrity concepts while contributing meaningful value to the healthcare organizations we serve.

This is a production-focused role with established productivity, quality, and performance expectations suited for individuals who thrive in being part of a high performing team environment. Successful team members consistently meet defined performance standards while maintaining a high degree of accuracy and attention to detail.

Kodiak is committed to creating a collaborative, supportive, and highly engaged team environment where people can do meaningful work, build their expertise, and enjoy being part of a growing business. As the DRG Validation practice continues to expand, team members have opportunities to broaden their capabilities, take on new challenges, and pursue professional growth and career advancement.

Qualifications

Required

• At least one of the following credentials is required: Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), or Certified Inpatient Coder (CIC).
• Minimum 5 years of inpatient coding, CDI, DRG validation, or revenue integrity experience with minimum 3 years performing as a DRG validator.
• Advanced knowledge of ICD-10-CM and ICD-10-PCS coding systems.
• Strong understanding of MS-DRG and APR-DRG methodologies.
• Excellent analytical, written, and verbal communication skills.
• Demonstrates strong computer literacy, with the ability to efficiently navigate electronic medical record (EMR) systems, DRG grouping software, Microsoft applications, and other technology platforms required to perform coding and clinical validation reviews.

Preferred

• Certified Documentation Integrity Practitioner (CDIP) or Clinical Documentation Integrity Specialist (CDIS)
• Knowledge of payer reimbursement methodologies.
• Experience with quality indicators, PSIs, HACs, and risk-adjustment methodologies.
• Prior consulting or client-facing experience.
• Familiarity with compliant physician query practices and clinical validation reviews.

What Makes Kodiak Different

• Growing business and meaningful opportunity - Join an established DRG Validation business experiencing strong year-over-year growth and continued investment in its future.
• Competitive total rewards - Receive competitive compensation and a comprehensive benefits package designed to support team members and their families.
• Invest in your professional credentials - Kodiak supports continued professional development by providing access to continuing education units (CEUs) and reimbursement for eligible credential renewals.
• Experienced, U.S.-based team - Collaborate with colleagues across the United States who bring deep expertise in coding, clinical validation, CDI, and revenue integrity.
• A culture built around people - Be part of a collaborative, supportive, and highly engaged team committed to its people and the healthcare organizations we serve.
• Opportunity to grow with us - Expand your expertise, take on new challenges, and pursue professional development and career advancement as the practice continues to grow
• Work that goes beyond traditional DRG validation - Build expertise across MS-DRG and APR-DRG reviews, coding and clinical validation, compliance, reimbursement integrity, and quality measures including HACs, PSIs, and Elixhauser measures.

Candidates must be legally authorized to work in the United States.  This position is not eligible for employment visa sponsorship now or in the future.