DRG QA & Training Lead — Elevate Clinical Validation

Machinify; Oregon; Hybrid; USD 130,000 - 150,000; Full time

Benefits offered by this job

Top Medical/Dental/Vision offerings

401(k) with company match

Tuition reimbursement

Flexible and empowering environment

Job summary

Machinify is seeking a DRG QA/Training Manager to lead the QA/Trainer team, own the audit program, and drive training aligned with coding and clinical validation guidelines.

You will partner with DRG Managers and the Educator to implement continuous improvements, develop training materials, and provide actionable feedback. This role supports a remote-working environment targeting healthcare payer clients.

Qualifications

• 5+ years of experience in healthcare billing and coding
• 3+ years of inpatient claims auditing, QA, or recovery auditing
• Previous supervisory experience required
• Experience with readmission reviews
• Proven ability to share DRG audit process knowledge with cross-functional teams

Responsibilities

• Lead the DRG QA/Trainer team, set goals, prioritize audit and training work
• Own the QA audit program for DRG Reviewers and ensure accuracy and compliance
• Oversee training for DRG methodologies and proprietary tools
• Develop QA policies, processes and training standards
• Collaborate with DRG Managers, Educator, and cross-functional partners on process improvements

Skills

DRG methodologies

MS-DRG

APR-DRG

AP-DRG

ICD-10-CM/PCS coding

Quality assurance

Training & coaching

Data analysis

Remote work experience

Communication

Education

Bachelor's in nursing

Health information management

Health administration

Tools

Microsoft Office (Excel, PowerPoint, Word)

Teams

Job description

Machinify is seeking a DRG QA/Training Manager to lead the QA/Trainer team, own the audit program, and drive training aligned with coding and clinical validation guidelines.

You will partner with DRG Managers and the Educator to implement continuous improvements, develop training materials, and provide actionable feedback. This role supports a remote-working environment targeting healthcare payer clients.