Diagnosis-Related Group (DRG) Trainer
Reporting to the Senior Manager of Training, the DRG Trainer plays a critical role in strengthening audit consistency, accuracy, and completeness by translating audit findings into targeted, effective learning experiences. This role supports the audit program by identifying learning gaps and delivering and reinforcing training, refreshers, coaching, and performance support that improves coding accuracy, audit quality, and accelerates trainee readiness for independent production in alignment with EXL standards.
The DRG Trainer partners closely with Quality Analysts, Auditors, and Subject Matter Experts to ensure training content remains current, relevant, and aligned with evolving coding requirements and audit expectations, while driving timely progression through training and successful graduation to operations.
A brief coding/auditing assessment may be included as part of the interview process
Salary for this role is $60,100 - $110,000 plus bonus
For more information on benefits and what we offer please visit us at https://www.exlservice.com/us-careers-and-benefits
The posted range is the hiring range for this role — a subset of the broader range available to employees over time — and reflects base salary across our national hiring scale. Final offers are based on several factors, including the candidate's skills and experience, internal pay equity, work location, market conditions for the role, and the specific scope and responsibilities of the position. The top of the range is reserved for candidates who notably exceed the requirements; the lower end applies to those with less experience or fewer preferred qualifications. For positions based in higher-cost zones (e.g., California, New York, New Jersey), actual compensation may exceed the posted range; your recruiter will share specifics during the process.
Responsibilities:
- Deliver onboarding training for new DRG auditors and refresher training for tenured auditors.
- Develop and maintain training content and modules related to medical coding and billing, including ICD-10-CM, CPT, and HCPCS
- Evaluate training effectiveness; analyze coding audit errors and audit trends to identify root causes and deliver targeted training or remediation.
- Mentor DRG auditors and provide coaching and performance feedback as needed.
- Conduct quality reviews related to initial audits and appeals in order to support training insights and skill reinforcement.
- Identify opportunities beyond standard audit findings that may result in additional recoveries and incorporate learnings into training.
- Maintain current knowledge of ICD-10-CM, ICD-10-PCS, CPT, and HCPCS coding guidelines.
- Track and consolidate learner performance data from quizzes, exams, and assessments, and present summarized insights during weekly meetings.
- Perform all responsibilities in accordance with company compliance, information security, and regulatory requirements.
- Perform other duties as assigned.
Knowledge and Skills:
- Demonstrated ability to facilitate instructor-led, virtual, and blended training for adult learners
- Ability to translate complex guidelines and audit concepts into clear, practical, and engaging learning experiences
- Strong analytical skills to identify error patterns, knowledge gaps, and training opportunities based on audit data
- Effective communication and facilitation skills, with the ability to engage learners and manage group dynamics in a virtual environment
- Ability to collaborate cross-functionally with Quality, Audit, and SME partners
- Strong organizational and time management skills to manage multiple priorities and deadlines
- Proficiency with training and collaboration tools (e.g., LMS, MS Teams, Excel, PowerPoint)
Qualifications:
- Bachelor’s degree or equivalent
- RHIT or RHIA certification required
- CCS or CPC certification required
- 5 plus years relevant DRG and APR DRG coding/auditing experience
- 3 plus years of experience in training, facilitation, or coaching within a coding, audit, or payment integrity setting
- Experience with Medicare Local Coverage Determinations (LCD) and National Coverage Determinations (NCD)
- Experience in coding audit, quality review, or payment integrity programs
- Experience delivering training, coaching, or mentoring new hires and/or tenured staff