DRG Clinical and Coding Educator- Remote

Gainwell Technologies LLC; Austin (TX); Remote; USD 87,000 - 115,000; Full time

Benefits offered by this job

Benefits from Day 1

Flexible vacation policy

Educational assistance

Leadership development academies

Job summary

Gainwell Technologies is seeking an experienced and innovative DRG Clinical & Coding Educator who develops, coordinates, and delivers comprehensive training for clinical reviewers, DRG validators, and coding auditors. This role serves as SME for DRG validation, APR-DRG, MS-DRG, ICD-10-CM/PCS guidelines, and other coding practices to ensure accuracy and compliance.

You will partner with Operations, Quality, and Leadership to identify educational needs, create materials, mentor teams, monitor

Qualifications

• At least 5 years in inpatient claims auditing, QA, or CDI.
• 5+ years in DRG validation, inpatient coding, APR-DRG and MS-DRG.
• 3+ years developing healthcare policy and Medicare/State regulatory education.
• 5+ years of professional medical coding with education/training/audit support.
• Experience with inpatient/outpatient coding rules.
• Familiar with identifying overpayments/underpayments.

Responsibilities

• Develop and deliver training for DRG auditors, coders, CDI teams, clinicians, and physicians.
• Create and maintain coding education materials, presentations, webinars, and content.
• Serve as SME for ICD-10, DRG validation, and coding guidelines.
• Mentor clinical teams to ensure audit and coding accuracy.
• Analyze quality trends and training needs; provide targeted education.
• Monitor quality metrics and implement educational improvements.
• Ensure training content complies with coding guidelines and policies.
• Maintain documentation of training activities and accreditation requirements.
• Support clinical claim reviews, quality audits, and appeals as needed.
• Maintain expertise in coding and clinical review processes.

Skills

DRG validation

Inpatient coding

Education program development

Auditing

Education

Associate degree in Health Information Management

Bachelor’s degree preferred

Registered Nurse License

Job description

It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development.

Summary

Gainwell Technologies is seeking an experienced and innovative DRG Clinical & Coding Educator who is responsible for developing, coordinating, and delivering comprehensive training programs for clinical reviewers, DRG validators, and inpatient/outpatient coding auditors. This role serves as the subject matter expert for DRG validation, APR-DRG, MS-DRG, assignment, ICD-10-CM/PCS coding guidelines, clinical documentation requirements, and payment integrity audit methodologies.The DRG Clinical & Coding Educator provides onboarding and ongoing education to ensure staff maintain a high level of coding accuracy, clinical competency, audit consistency, and compliance with industry standards. This position partners closely with Operations, Quality, and Leadership teams to identify educational needs, address knowledge gaps, and support continuous quality improvement initiatives.

Your role in our mission

• Develop and deliver training programs for DRG auditors, coders, CDI teams, clinicians, and physicians.
• Create and maintain coding education materials, presentations, webinars, and training content.
• Sserve as an ICD-10, DRG validation, and coding guidelines subject matter expert (SME).
• Mentor and coach clinical teams to ensure audit and coding accuracy.
• Analyze quality trends and training needs, and provide targeted education.
• Monitor quality metrics and implement educational improvements.
• Ensure training content complies with coding guidelines, regulations, and clinical policies.
• Maintain documentation of training activities and accreditation requirements.
• Support clinical claim reviews, quality audits, and appeals as needed.
• Maintain expertise in coding, clinical review processes, workflows, and industry standards.

What we're looking for

• Education: Associates degree in Health Information Management, Nursing, Clinical Sciences or related healthcare fields required, Bachelor’s Degree preferred.
• License/Certification: Current, active and unencumbered Registered Nurse License, Inpatient Coding Certification (CCS, CIC, CCDS, CDIP, CPMA, RHIA, RHIT)
• Minimum of 5 years experience in inpatient claims auditing, quality assurance, or clinical documentation integrity.
• Minimum of 5 years of experience performing DRG Validation Audits, inpatient coding, with extensive experience in APR DRG as well as MS DRG.
• 3+ years of experience with developing education programs related to healthcare policy, Medicare guidelines and State regulation research and interpretation.
• 5+ years of professional medical coding experience, including experience supporting coding education, training, quality review, and audit activities
• Experience applying inpatient hospital and outpatient facility coding and billing rules
• Understanding of clinical claims review audit techniques, identifying overpayments/underpayments, or other identification of revenue opportunities

What you should expect in this role

• Remote within the U.S.
• Full-time position
• Benefits effective on Day 1
• All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a , and educational assistance.
• We also have a variety of leadership and technical development academies to help build your skills and capabilities.
• Salary: $86,800.00-$115,000.00 per year

Applications accepted through October 30, 2026.

We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our and visit our for all available job role openings.

Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Gainwell Technologies defines “wages” and “wage rates” to include “all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.