Inpatient Audit Specialist

🕒 February 18

🇺🇸 United States – Remote

💵 $35 - $45 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

💻 IT Support

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Datavant

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2017

⚕️ Healthcare Insurance

☁️ SaaS

🏢 Enterprise

💰 $40M Series B on 2020-10

Healthcare Insurance • SaaS • Enterprise

Datavant is a company that provides a platform and network focused on making health data secure, accessible, and usable across the healthcare ecosystem. With a focus on data connectivity and interoperability, Datavant facilitates the movement of healthcare records across a vast network of organizations, including hospitals, clinics, health systems, and data partners. Their suite of products and solutions covers areas such as health data exchange, data transformation, and privacy compliance, serving various clients including health plans, healthcare providers, life sciences, and government organizations. Datavant's mission is to advance human health through improved data exchange and analytics.

📋 Description

• Conduct inpatient coding audits on medical records, utilizing ICD-10-CM, CPT, and appropriate coding references for accurate DRG and APC assignment • Review non-CC/MCC records to assess proper coding or identify the need for additional documentation. Scrutinizes all HCPCS and CPT codes influencing APC assignment • Provide coder education through the auditing process • Prepare preliminary results for review by the facility or CCS HIM director • Review disagreements on APC/DRG changes with the appropriate manager • Prepare the final reports for the coding audit and actively participates in the resolution of audit findings • Provide coder education via email and/or conference calls, utilizing the audit spreadsheet findings and comments • Attend coding workshops as necessary • Stay current with regulatory changes • Organize and prioritize multiple cases concurrently to ensure departmental workflow and prompt case resolution • Demonstrate versatility and exceptional work across a wide range of coded services • Meet with client facility representatives to discuss issues and trends identified in audits • Develop and implement education for physicians, nursing, and other clinical staff to enhance documentation • Communicate effectively with co-workers, management, and hospital staff regarding clinical and reimbursement issues • Function in a professional, efficient, and positive manner • Adhere to the American Health Information Management Association’s code of ethics • Maintain a customer-service focus and exhibits professionalism, flexibility, dependability, a desire to learn, commitment to excellence, and commitment to the profession • Conduct audits on external coding staff as needed and provides reports to the manager as directed • Handle a high complexity of work functions and decision-making • Demonstrate strong organizational, teamwork, and leadership skills

🎯 Requirements

• 3+ years experience coding and auditing • Associate or Bachelor's degree from an AHIMA-certified HIM or Nursing Program, or completion of a certificate program from AAPC with a preference for CCS • Preferred: CCS, RHIT, or RHIA credentials • Recent experience in academic/level 1 trauma centers • Experience coding and auditing inpatient and outpatient records for various facilities • Track record of acceptable productivity standards • Maintain 95% accuracy rate for APC assignment and 95% productivity rate • Experience with various software including EMR, Encoder and Auditing software

🏖️ Benefits

• Medical • Dental • Vision • 401k Savings Plan w/match • 2 weeks of paid time off • Paid Holidays • Floating Holidays • Free CEUs every year • Stipend provided to assist with education and professional dues (AHIMA/AAPC) If Applicable • Equipment: monitor, laptop, mouse, headset, and keyboard • Comprehensive training led by a credentialed professional coding manager • Exceptional service-style management and mentorship (we’re in this together!)