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About the role
Key responsibilities & impact- 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
Requirements
What you’ll need- 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
Benefits
Comp & perks- 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
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
inpatient claims auditingquality assuranceclinical documentation integrityDRG methodologiesclinical validationtrainingauditingreport generationfeedback provisionworkflow efficiency
Soft Skills
collaborationconstructive feedbackcommunicationmentoringperformance enhancementcontinuous improvementdocumentationguidancerecognitionexpert resource
Certifications
RHIARHITCCDSCDIPCCS
