DRG Clinical & Coding Educator

Job not on LinkedIn

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $86k - $115k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Gainwell Technologies

WebsiteLinkedInAll Job Openings

10,000+ employees

💼 Consulting

📦 Logistics

⚕️ Healthcare Insurance

💰 Grant on 2023-06

Consulting • Logistics • Healthcare Insurance

Gainwell Technologies is the nation’s leading provider of digital and cloud-enabled solutions across the human services and public health ecosystem. With a mission-driven approach, Gainwell serves clients in all 50 U. S. states, focusing on improving health outcomes and delivering intuitive, human-centered experiences. Their comprehensive suite of solutions includes Medicaid Enterprise modernization, data analytics, provider services, and pharmacy solutions, all designed to advance the future of healthcare and enhance community well-being.

📋 Description

• Develop and deliver training programs for DRG auditors and clinical review staff • Train coders, CDI teams, and physicians on documentation, coding, and DRG assignment • Create and maintain training materials, presentations, and educational content • Serve as a subject matter expert on ICD-10-CM/PCS, coding guidelines, and DRG validation • Provide coaching, mentoring, and ongoing education to support team performance • Collaborate with clinical and quality teams to identify training needs and improve outcomes • Monitor quality metrics and implement targeted educational interventions • Ensure training content complies with coding guidelines, regulations, and clinical policies • Maintain training documentation and accreditation standards • Perform clinical claim reviews, coding audits, and appeals as needed

🎯 Requirements

• Associate degree in Health Information Management, Nursing, Clinical Sciences, or a related healthcare field required • Current, active, and unencumbered Registered Nurse (RN) license required • Inpatient Coding Certification required: CCS, CIC, CCDS, CDIP, CPMA, RHIA, or RHIT • Minimum of 5 years of experience in inpatient claims auditing, quality assurance, or clinical documentation integrity • Minimum of 5 years of experience performing DRG validation audits and inpatient coding • Extensive experience with both APR-DRG and MS-DRG • 3+ years of experience developing educational programs related to healthcare policy, Medicare guidelines, and state regulation research and interpretation • 5+ years of professional medical coding experience, including coding education, training, quality review, and audit activities • Experience applying inpatient hospital and outpatient facility coding and billing rules • Strong understanding of clinical claims review audit techniques, including identifying overpayments, underpayments, and revenue enhancement opportunities • Up to 10% travel required • Bachelor's degree preferred

🏖️ Benefits

• Flexible hours • Work-life balance • Continuous learning • Career development • Flexible vacation policy • 401(k) employer match • Comprehensive health benefits • Educational assistance • Leadership and technical development academies • Up to 10% travel required