Remote Clinical DRG Auditor | Coding Expert & Opportunity

Gainwell Technologies LLC; Austin (TX); Remote; USD 90,000 - 105,000; Full time

Benefits offered by this job

Flexible vacation policy

Educational assistance

Leadership development academies

Job summary

Gainwell Technologies is seeking a Clinical DRG Auditor to perform DRG validation reviews of medical records, coding accuracy, and documentation support. The role requires extensive clinical auditing experience, RN licensure, and specialty in MS-DRG/APR-DRG coding, with proficiency in ICD-10 guidelines and CMS rules.

The candidate will work remotely within the United States, traveling up to 10% as needed, and contribute to training new Coders and Auditors while maintaining certifications and

Qualifications

• Active, unrestricted RN license in the United States.
• Coding certifications required and maintained as a condition of employment.
• Minimum 3+ years clinical inpatient hospital experience.
• 2+ years MS-DRG/APR-DRG coding or auditing experience with ICD-10 guidelines.
• Expert knowledge of ICD-10-CM and DRG methodologies.
• Strong computer skills and ability to use auditing tools and virtual meeting software.

Responsibilities

• Audits medical record documentation for accuracy of principal and secondary diagnoses and procedures.
• Adheres to coding guidelines, clinics, and regulatory mandates.
• Substantiates conclusions with ICD-10 coding expertise and clinical knowledge.
• Document audit determinations and rationale in HMS systems.
• Apply coding judgment for sequencing and DRG determinations.
• Assist management by training new Coders and Auditors.

Skills

MS-DRG/APR-DRG coding

ICD-10 coding expertise

Clinical auditing

HMS auditing systems

Proficiency in MS Office & virtualMeet

Training/mentoring

Education

RN licensure (US)

Coding Certifications (RHIA/RHIT/CCS/CIC/CCDS/CPC)

Tools

HMS proprietary auditing system

MS Teams / Zoom

Job description

Gainwell Technologies is seeking a Clinical DRG Auditor to perform DRG validation reviews of medical records, coding accuracy, and documentation support. The role requires extensive clinical auditing experience, RN licensure, and specialty in MS-DRG/APR-DRG coding, with proficiency in ICD-10 guidelines and CMS rules.

The candidate will work remotely within the United States, traveling up to 10% as needed, and contribute to training new Coders and Auditors while maintaining certifications and