DRG QA, Trainer

🕒 July 2

🇺🇸 United States – Remote

💵 $100k - $120k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

🔧 QA Engineer (Quality Assurance)

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 43%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.Why this score:

• Open for 136 days.
• Jobs at this company usually fill in 36 days.
• Reposted once.

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Machinify

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

💼 Consulting

📦 Logistics

💰 $10M Series A - Machinify on 2018-10

Healthcare • Consulting • Logistics

Machinify is a healthcare-focused AI platform and services company that reshapes healthcare payments and payment integrity. Its AI operating system unifies claims, medical records, contracts, and policies, and uses foundation models and task-specific agents to automate and improve coding, payment accuracy, recoveries, and cost avoidance. Machinify serves health plans (including 18 of the top 20), supports insourced, hybrid, or fully-managed deployments, and emphasizes measurable outcomes — reporting 85+ customers, 270M member lives covered, and $6B+ in annual cost avoidance and recoveries.

📋 Description

• Oversee quality assurance for DRG Reviewers • Review and audit new and existing DRG Reviewers’ work for accuracy, compliance, and alignment with coding and clinical validation guidelines • Provide detailed, constructive feedback and recognize high-performance results • Collaborate with management to improve audit accuracy, workflow efficiency, and reviewer performance • Conduct supplemental training for new hires on DRG methodologies, clinical validation, and proprietary tools • Provide ongoing training on policy updates, skill development, and performance enhancement • Contribute to training materials and resources with the educator • Maintain documentation of audit findings, feedback sessions, and training activities • Generate QA and training-effectiveness reports for management • Work with team leaders and the educator to align training and QA processes with company standards and objectives • Serve as an expert resource, answering questions and guiding staff on complex cases and procedures

🎯 Requirements

• 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 • One or more required certifications: RHIA, RHIT, CCDS, CDIP, or CCS • 2+ years of experience in inpatient claims auditing, quality assurance, or clinical documentation integrity • 1+ year of experience in a training or mentoring capacity • Ability to provide clear, actionable feedback to team members • Strong organizational and time management skills • Excellent written and verbal communication • High standards for quality and attention to detail • Demonstrated ability to work independently and in teams • Strong knowledge of DRG methodologies (MS & APR), ICD-10-CM/PCS coding, and UHDDS definitions • Expertise in clinical criteria documentation and healthcare coding rules and regulations • Experience working with multiple monitors • Proven success in a remote working environment • Proficient in Windows office systems, including the full Microsoft Suite and Teams • Advanced skills in Microsoft Office (Excel, PowerPoint, Word) • Experience with various software applications and collaboration with development teams • Familiarity with multiple encoder/grouper applications

🏖️ Benefits

• 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 • Bonus potential

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