Gainwell Technologies
Gainwell Technologies
Gainwell Technologies develops digital and cloud-enabled solutions for the human services and public health ecosystem. The company works with clients across all 50 U.S. states on healthcare initiatives including Medicaid Enterprise modernization, data analytics, provider services, and pharmacy solutions. Its work connects technology with public health delivery, healthcare administration, and efforts to improve health outcomes and community well-being.

Senior Associate Coding Auditor

Audit inpatient medical records and validate ICD-10, DRG, and procedure coding. Support Gainwell Technologies’ claims operations through audit documentation and coding auditor training.

Description

  • Audit medical records for accurate principal and secondary diagnoses, including MCCs and CCs, and procedure codes.
  • Follow official coding guidelines, coding clinic guidance, regulatory requirements, and mandates.
  • Use advanced ICD-10 coding knowledge to support audit findings.
  • Record audit decisions and supporting rationale in HMS proprietary systems.
  • Meet management’s productivity and quality standards consistently.
  • Cross-train to review multiple claim types and support client needs.
  • Help train new coding auditors through daily monitoring, mentoring, feedback, and education.
  • Keep coding knowledge current and complete required continuing education units.
  • Attend training and scheduled meetings to build knowledge of clinical policies, procedures, rules, and regulations.

Requirements

  • Hold an active AHIMA or AAPC professional credential for at least one year: CPC, CCS, COC, RHIA, or RHIT.
  • Have at least three years of inpatient or outpatient claims coding experience.
  • Demonstrate proficiency in medical record auditing and ICD-10-CM, ICD-10-PCS, APC, ASC, HCPCS, and CPT coding methods.
  • Demonstrate thorough knowledge of APR-DRG, AP-DRG, and MS-DRG.
  • Have experience in medical record coding and auditing.
  • Maintain coding certification through required continuing education units (CEUs).

Benefits

  • Benefits begin on the first day of employment.
  • Training and leadership opportunities provide a path to advancement.
  • Remote work-from-home role within the United States.

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