Senior DRG Coding & CDI Educator — Remote

Gainwell Technologies; Town of Texas, Northern (WI, KY); Hybrid; USD 86,000 - 115,000; Full time

Benefits offered by this job

Generous vacation policy

401(k) employer match

Health benefits

Job summary

Gainwell Technologies is seeking an experienced DRG Clinical & Coding Educator to develop, coordinate, and deliver training for clinical reviewers, DRG validators, and coding auditors. The role serves as an SME on DRG validation, ICD-10-CM/PCS guidelines, and clinical documentation requirements, ensuring high coding accuracy and compliance.

The educator will onboard staff, partner with Operations and Quality teams, and drive quality improvements through targeted education and accreditation

Qualifications

• Associate degree in Health Information Management or related field; Bachelor’s degree preferred.
• Current RN license required.
• Inpatient Coding Certification (CCS, CIC, CCDS, CDIP, CPMA, RHIA, RHIT) required.
• Minimum 5 years in inpatient claims auditing or clinical documentation integrity.
• At least 5 years of DRG validation audits with APR-DRG and MS-DRG experience.
• 3+ years developing educational programs on healthcare policy, Medicare guidelines, and state regulation interpretation.
• 5+ years of professional medical coding experience including education, QA, and audits.
• Experience applying inpatient and outpatient coding and billing rules.

Responsibilities

• Develop and deliver training programs for DRG auditors and clinical review staff.
• Train coders, CDI teams, and physicians on documentation, coding, and DRG assignment.
• Create and maintain training materials, presentations, and content; serve as SME on ICD-10-CM/PCS and DRG validation.
• Provide coaching and ongoing education to support team performance.
• Collaborate with operations, quality, and leadership to identify training needs.
• Monitor quality metrics and implement targeted educational interventions.
• Ensure training content complies with coding guidelines and policies.
• Maintain training documentation and accreditation standards.
• Perform clinical claim reviews, coding audits, and appeals as needed.

Skills

RN license

Inpatient coding

Auditing

Coding education

Documentation integrity

Education

Associate degree in Health Information Management

Bachelor’s degree preferred

Inpatient Coding Certification (CCS, CIC, CCDS, CDIP, CPMA, RHIA, RHIT)

Job description

Gainwell Technologies is seeking an experienced DRG Clinical & Coding Educator to develop, coordinate, and deliver training for clinical reviewers, DRG validators, and coding auditors. The role serves as an SME on DRG validation, ICD-10-CM/PCS guidelines, and clinical documentation requirements, ensuring high coding accuracy and compliance.

The educator will onboard staff, partner with Operations and Quality teams, and drive quality improvements through targeted education and accreditation