DRG QA Trainer

🕒 Maio 12

🇺🇸 Estados Unidos – Remoto (EUA)

💵 $100.000 - $120.000 / ano

⏰ Tempo Integral

🟢 Júnior

🟡 Pleno

🔧 Engenheiro de QA (Qualidade de Software)

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Machinify

SiteLinkedInTodas as Vagas

1001 - 5000 funcionários

⚕️ Seguro de Saúde

🤖 Inteligência Artificial

☁️ SaaS

💰 $10.000.000 Series A - Machinify em 2018-10

Healthcare Insurance • Artificial Intelligence • SaaS

A Machinify é uma empresa de plataforma e serviços de IA focada em saúde que transforma pagamentos e a integridade de pagamentos no setor. Seu sistema operacional de IA unifica reivindicações, prontuários médicos, contratos e políticas, utilizando modelos fundamentais e agentes específicos de tarefas para automatizar e aprimorar a codificação, precisão de pagamentos, recuperações e prevenção de custos. A Machinify atende planos de saúde (incluindo 18 dos 20 maiores), oferece implantações internalizadas, híbridas ou totalmente gerenciadas e enfatiza resultados mensuráveis — relatando mais de 85 clientes, 270 milhões de vidas cobertas e mais de 6 bilhões de dólares em prevenção de custos e recuperações anuais.

Descrição

• Review and audit the work of new and existing DRG Reviewers to ensure accuracy, compliance, and alignment with established coding and clinical validation guidelines. • Provide constructive, detailed feedback to DRG Reviewers, highlighting areas for improvement and recognizing high-performance results • Collaborate with management to promote continuous improvement in audit accuracy, workflow efficiency, and reviewer performance • Assist the educator by conducting supplemental training sessions for new hires on DRG methodologies, clinical validation, and proprietary tools • Provide ongoing training to existing staff, focusing on policy updates, skill development, and performance enhancement • Maintain comprehensive documentation of audit findings, feedback sessions, and training activities • Generate reports on the quality assurance results and the effectiveness of training sessions for review by management • Work closely with team leaders and the educator to ensure the training and QA processes align with the company’s standards and objectives • Serve as an expert resource for DRG Reviewers and other staff members, answering questions and offering guidance on complex cases or procedures

🎯 Requisitos

• Associate or bachelor’s degree in nursing, health information management, or a related field • Relevant work experience may be considered in lieu of formal education • RHIA - Registered Health Information Administrator • RHIT - Registered Health Information Technician • CCDS - Certified Clinical Documentation Specialist • CDIP - Clinical Documentation Improvement Practitioner • CCS - Certified Coding Specialist • 2+ years of experience in inpatient claims auditing, quality assurance, or clinical documentation integrity • 1+ year of experience in a training or mentoring capacity

🏖️ Benefícios

• Work from anywhere in the US! Machinify is digital-first. • Top Medical/Dental/Vision offerings • FSA/HSA • Tuition reimbursement • Competitive salary, 401(k) with company match • Additional health and wellness benefits and perks • Flexible and trusting environment where you’ll feel empowered to do your best work