Remote DRG QA & Training Manager

Rawlings Company; United States; Remote; USD 130,000 - 150,000; Full time

Benefits offered by this job

Top Medical/Dental/Vision

401(k) with company match

Tuition reimbursement

FSA/HSA

Flexible work environment and autonomy

Job summary

Machinify seeks a DRG QA/Training Manager to lead the QA/Trainer team supporting DRG Clinical Validation, MS-DRG and APR-DRG validation. You will own audit programs, onboard reviewers, and drive training aligned with coding standards.

Work with cross-functional partners to identify improvements and ensure audits meet quality targets. The role requires nursing or health information/administration background, leadership experience, and deep knowledge of DRG systems.

Qualifications

• 5+ years in healthcare billing and coding.
• 3+ years inpatient claims auditing or related experience.
• Previous supervisory experience required.

Responsibilities

• Lead DRG QA/Trainer team, set goals, prioritize audit/training work.
• Own QA audit program for DRG Reviewers and ensure accuracy.
• Collaborate with leadership to drive continuous QA improvements.
• Provide feedback and coaching to staff to improve performance.

Skills

DRG methodologies

ICD-10-CM/PCS

Auditing

Coaching staff

Data analytics

Quality improvement

Communication

Independent work

Education

Bachelor's degree in Nursing

Health Information Management

Health Administration

Tools

Windows Office

Microsoft Excel

Teams

Job description

Machinify seeks a DRG QA/Training Manager to lead the QA/Trainer team supporting DRG Clinical Validation, MS-DRG and APR-DRG validation. You will own audit programs, onboard reviewers, and drive training aligned with coding standards.

Work with cross-functional partners to identify improvements and ensure audits meet quality targets. The role requires nursing or health information/administration background, leadership experience, and deep knowledge of DRG systems.