Inpatient Quality Assurance - Academy

Actively Reviewing the Applications

Med-Metrix

4–8 years

Posted 3 days ago • Apply by June 11, 2026

Job Description

Job Purpose

The Educator – Inpatient Quality Assurance – Academy is responsible for elevating coding accuracy and compliance through targeted education driven by QA findings. This role bridges quality assurance and training by designing evidence-based curricula, leading corrective coaching, and monitoring knowledge application across inpatient coders. The Educator – Inpatient Quality Assurance ensures alignment with official guidelines and payer-specific rules, supports rebuttal resolution, and drives sustained performance improvement reflected in reduced error rates and improved DRG integrity.

Duties & Responsibilities

Develop and deliver structured education plans based on QA audit trends (e.g., principal diagnosis selection, MCC/CC capture, PCS root operations, device qualifiers, sequencing rules, POA indicators)
Create modular learning content (micro-lessons, job aids, case-based workshops, checklists, reference packs) for targeted gaps
Facilitate 1:1 coaching and small group sessions, incorporating live case simulations and retrospective chart reviews
Perform QA reviews on assigned coding samples to ensure accuracy, compliance, and adherence to client-specific guidelines
Analyze audit outcomes to identify error patterns, contributing factors, and root causes; translate findings into actionable education
Validate error classification, consistency, and hierarchy application; support rebuttal assessment with evidence-based rationale
Maintain and update an education backlog tied to high-impact error clusters and payer denials
Ensure all training aligns with ICD-10-CM/PCS Official Guidelines, CMS MS-DRG grouping logic, UHDDS definitions, Coding Clinic guidance, POA reporting, and facility- or payer-specific policies
Monitor guideline changes and cascade updates, update materials and sessions in a timely manner
Define and track education effectiveness metrics (pre/post assessments, error rate deltas, DRG change rates, denial events, audit pass rates)
Publish weekly/monthly dashboards on education outcomes and risk hotspots; present at Ops/QA touchpoints
Partner with Operations leads to schedule education without disrupting throughput, coordinating follow-ups and reinforcement plans
Work closely with QA Supervisors, Operations Managers, Trainers, and onshore clients to align on expectations, sampling, glidepaths, and timelines
Contribute to playbook standardization across accounts, support rollout of QA forms, templates, and rebuttal workflows
Other duties as assigned
Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
Understand and comply with Information Security and HIPAA policies and procedures at all times
Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties

Qualifications

Required

Bachelor’s degree in a health-related field (e.g., Nursing, Allied Health, HIM) or equivalent experience
Must have CCS/CIC certification
Solid 3 years of Inpatient DRG QA experience
Demonstrated experience designing and delivering coder education based on QA data
Proficiency in Microsoft Office Suite
Strong interpersonal skills, ability to communicate well at all levels of the organization
Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses
High level of integrity and dependability with a strong sense of urgency and results oriented
Excellent written and verbal communication skills required
Gracious and welcoming personality for customer service interaction

Preferred

Strong command of principal diagnosis selection, MCC/CC capture, PCS approach/device/qualifier logic, sequencing, POA assignment, UHDDS definitions, and DRG validation
Error taxonomy, root cause analysis, sampling strategies, rebuttal review, trend analysis
Proficiency with encoder/groupers, EHR/chart review tools, QA dashboards (Excel/Sheets), and documentation platforms (Word/Docs, PPT)
Stakeholder alignment, change management, time management, and organized follow-through

Working Conditions

Schedule flexibility for cross-geo collaboration
Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear
Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress
Work Environment: The noise level in the work environment is usually minimal

Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.