DRG Quality Assurance Trainer

Job Summary

To ensure high standards of quality assurance, the remote DRG Quality Assurance Trainer will oversee the auditing of DRG Reviewers, conduct training sessions, and provide detailed feedback while fostering a culture of continuous improvement.

Key responsibilities

• Review and audit the work of DRG Reviewers for compliance with clinical and coding standards
• Conduct training sessions for new hires and provide ongoing training for existing staff on DRG methodologies and policy updates
• Maintain documentation of audit findings and training activities, generating reports for management review

Required qualifications

• Associate or bachelor's degree in nursing, health information management, or a related field
• Certifications such as RHIA, RHIT, CCDS, CDIP, or CCS are required
• 2+ years of experience in inpatient claims auditing or clinical documentation integrity
• 1+ year of experience in a training or mentoring capacity
• Strong knowledge of DRG methodologies and healthcare coding regulations