Inpatient Coding Auditor, Senior Associate- Remote
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Gainwell Technologies LLC
OH
Summary
The Senior Associate performs audits of inpatient medical records to ensure the accuracy of diagnosis and procedure coding according to regulatory guidelines. They also provide mentorship and training to other auditors while maintaining productivity and quality standards.
Job Description
It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development.
Summary
We are seeking a talented individual for an Inpatient Coding Auditor, Senior Associate who is responsible for performing coding reviews of inpatient medical records and/or other documentation to determine correct coding, as defined by review methodologies specific to the contract for which review services are being provided. This involves accessing proprietary systems to audit medical records, accurately document findings, and provide policy/regulatory support for determinations. The candidate must have an extensive background in either facility-based inpatient coding and/or outpatient coding edits and a high level of understanding of reimbursement guidelines, specifically the MS-DRG, AP-DRG, APR-DRG, ASC, and APC payment systems.
Your role in our mission
- Performs audits of inpatient medical record documentation to determine the accuracy of principal and secondary diagnosis (including MCCs and CCs) and procedure codes. Validates the assignment and sequencing of ICD-10 codes, discharge status, Hospital-Acquired Conditions, POA assignment, and DRG assignment. Adheres to official coding guidelines, Coding Clinic guidance, and regulatory mandates. Draws on advanced ICD-10 coding expertise to substantiate conclusions. Utilizes proprietary auditing systems with a high level of proficiency to document audit determinations and rationale.
- Consistently achieves productivity and quality performance standards established by management.
- Actively cross-trains to perform reviews of multiple claim types to provide a flexible workforce that meets client needs.
- Assists management with training new Coding Auditors, including daily monitoring, mentoring, feedback, and education.
- Maintains current knowledge of coding guidelines and successfully completes required CEUs to maintain coding certification.
- Responsible for attending training sessions and scheduled meetings to enhance skills and working knowledge of clinical policies, procedures, rules, and regulations.
What we're looking for
- One or more active professional credentials through AHIMA or AAPC (CPC, CCS, COC, RHIA, RHIT); required.
- 2+ years of experience in inpatient medical record coding and/or auditing; required.Demonstrated proficiency in medical record auditing and ICD-10-CM, ICD-10-PCS, APC, ASC, HCPCS, and CPT coding methodologies.
- Demonstrates a thorough understanding of APR-DRG, AP-DRG, and MS-DRG.
- Demonstrated experience in medical record coding and auditing.
- Demonstrated proficiency in computer skills and typing, including Microsoft Windows, Outlook, Excel, Word, PowerPoint, internet browsers, and virtual meeting tools such as Microsoft Teams and Zoom.
What you should expect in this role
- Remote within the U.S.
- Benefits on the first day of employment.
- Clear path for advancement with training and leadership opportunities.
- 0-10% travel.
The application period will remain open until October 18, 2026.
The pay range for this position is $54,100.00 - $77,300.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.
We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.
Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Gainwell Technologies defines “wages” and “wage rates” to include “all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.
The people who build careers at Gainwell Technologies share one thing: they want their work to matter. Here, it does.
We're the essential ingredient that makes Medicaid work.
For more than 50 years, we've combined our sweeping scale and technology to turn complex policies into thriving programs. We act as the crucial connection bringing the U.S. healthcare ecosystem together, and we partner with state agencies to modernize public health.
Our solutions translate complex member data into meaningful action. We streamline administration, connect vital systems, and drive efficiency. This gives providers more time to focus on delivering quality care to the people who need it most.
When we bring Medicaid touchpoints to life, members thrive. From fighting fraud and recovering improper payments to speeding up verifications, every solution we deploy expands what's possible for the future of healthcare.
Less burden, more mission. Gainwell.
Company size
10,001+ employees
Industry
IT Services and IT Consulting
Org type
Privately Held
Headquarters
United States
The people who build careers at Gainwell Technologies share one thing: they want their work to matter. Here, it does.
We're the essential ingredient that makes Medicaid work.
For more than 50 years, we've combined our sweeping scale and technology to turn complex policies into thriving programs. We act as the crucial connection bringing the U.S. healthcare ecosystem together, and we partner with state agencies to modernize public health.
Our solutions translate complex member data into meaningful action. We streamline administration, connect vital systems, and drive efficiency. This gives providers more time to focus on delivering quality care to the people who need it most.
When we bring Medicaid touchpoints to life, members thrive. From fighting fraud and recovering improper payments to speeding up verifications, every solution we deploy expands what's possible for the future of healthcare.
Less burden, more mission. Gainwell.
Company size
10,001+ employees
Industry
IT Services and IT Consulting
Org type
Privately Held
Headquarters
United States