Gainwell Technologies

Associate Manager, Inpatient/Outpatient Coding Review- Remote

Gainwell Technologies  •  $85k - $109k/yr  •  Texas (Remote)  •  3 hours ago
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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.

We are seeking a talented individual for an Associate Manager, Inpatient/Outpatient Coding Review who is responsible for supervising a multidisciplinary team of Certified Coders, Clinical DRG Auditors, and Nurse Reviewers to audit inpatient and outpatient medical records to determine correct coding as defined by review methodologies specific to the contract for which review services are being provided. This role plays a critical part in identifying coding discrepancies and recoverable claim opportunities, and supporting regulatory integrity on behalf of our clients.

Your role in our mission

  • Supervise the quality review program, creating policies and processes relating to quality and ensuring continuous conformance with appropriate standards, regulations, and contractual agreements.
  • Develop, implement, and maintain quality assurance processes and performance benchmarks for DRG validation, inpatient coding, and outpatient coding/billing audits.
  • Supervise and mentor clinical auditors and coding specialists; provide education, coaching, and performance feedback.
  • Monitor and report key performance indicators (KPIs) for audit accuracy, productivity, and interrater reliability.
  • Identify trends, root causes, and opportunities for improvement in documentation or coding accuracy.
  • Analyze audit results, denial trends, and payer findings to identify systemic issues and recommend corrective actions.
  • Prepare and present regular reports and dashboards for leadership, highlighting performance metrics, audit outcomes, and improvement initiatives.
  • Support compliance and revenue integrity efforts by ensuring the accuracy of coded data used for reimbursement, quality reporting, and analytics.
  • Develop and deliver training programs for coding, clinical, and quality assurance teams.
  • Stay current with evolving CMS regulations, ICD-10-CM/PCS updates, and industry standards for inpatient coding and DRG assignment.
  • Drive continuous quality improvement initiatives to enhance effectiveness and efficiency.
  • Serve as a Subject Matter Expert to assess new tools, automation, product development, and clinical readiness; act as a resource for resolving escalated issues, and coach and mentor staff to develop a high-performing team.
  • Manage and evaluate individual and team performance, and take appropriate action to meet and/or exceed performance standards.
  • Perform other functions as assigned.

What we're looking for

  • At least one of the following active Coding Certifications is required and is to be maintained as a condition of employment: RHIA, RHIT, CCS, CIC, CCDS or CPC
  • 5+ years inpatient or outpatient coding/auditing required
  • Working knowledge of ICD-10 CM, ICD-10-PCS, APC, ASC, HCPCS, CPT coding and DRG reimbursement methodologies strongly preferred
  • Bachelor’s degree in business, healthcare administration, or related field preferred
  • 2+ year’s management or supervisory experience preferred

What you should expect in this role

  • Home based position and you must have a work location within the continental US
  • This position requires that you provide high speed internet connection and a work environment free from distractions
  • Ability to work during normal business hours as this position requires frequent interactions with the team and other departments within the company
  • May be required to work extended hours for special business needs
  • May be required to travel at least 10% of time based on business needs

The application period will remain open until September 4, 2026.

The pay range for this position is $85,000.00 - $109,200.00 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.

Gainwell Technologies

About Gainwell Technologies

For 50 years, our nation’s federal Medicaid program has worked to improve the health, safety and well-being of America’s most vulnerable populations: low-income families, women and children, seniors, and those with disabilities. With positive health and cost outcomes that pierce inequities and impact economies, the success of these programs is inextricably tied to the prosperity of communities, individual states and the nation as a whole. We think that demands respect and, more importantly, is deserving of a lifetime commitment from innovators who can help those who operate within and around health and human services evolve — in any market at any stage. At Gainwell Technologies, that’s our sole focus.

Built across more than five decades, Gainwell has intentionally seized opportunities to advance its digitally enabled services to meet agencies, health plans and MCOs where they are on their modernization journeys and propel them into the future of public health. Our commitment to innovation, deep experience and ability to leverage insights from customers across 50 states has allowed us to expand on next-generation, cloud-enabled technologies.

Today, Gainwell offers one of the most comprehensive suites of scalable services and solutions on the market — all proven to deliver cost savings, better patient outcomes and an improved provider experience. Equally important to our expanding technologies and results: We bring ideas that bring policies to life.

Industry
IT & Software
Company Size
10,000+ employees
Headquarters
United States
Year Founded
Unknown
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