Senior Associate, Outpatient Coding Auditor

🕒 May 12

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Gainwell Technologies

10,000+ employees

⚕️ Healthcare Insurance

💰 Grant on 2023-06

Healthcare Insurance • Human Services • Healthcare

Gainwell Technologies is the nation’s leading provider of digital and cloud-enabled solutions across the human services and public health ecosystem. With a mission-driven approach, Gainwell serves clients in all 50 U. S. states, focusing on improving health outcomes and delivering intuitive, human-centered experiences. Their comprehensive suite of solutions includes Medicaid Enterprise modernization, data analytics, provider services, and pharmacy solutions, all designed to advance the future of healthcare and enhance community well-being.

📋 Description

• Performs audits of medical record documentation to determine the accuracy of principal and secondary diagnosis (including MCC & CC) and procedure codes. • Adheres to official coding guidelines, coding clinics and regulatory guidelines and mandates. • Draws on advanced ICD-10 coding expertise to substantiate conclusions. • Utilizes proprietary auditing systems with a high level of proficiency to document audit determinations and rationale. • Consistently achieves productivity and quality performance standards established by management. • Actively cross-trains to perform reviews of multiple claim types to provide a flexible workforce to meet client needs • Assists management with training new Coding Auditors to include daily monitoring, mentoring, feedback and education. • Maintains current knowledge of coding guidelines and successfully completes required CEUs to maintain coding certification. • Responsible for attending training and scheduled meetings to enhance skills and working knowledge of clinical policies, procedures, rules, and regulations.

🎯 Requirements

• One or more active professional credentials through AHIMA or AAPC: CPC, COC, CCS, RHIA, RHIT; required • 2+ years experience of outpatient medical record coding and/or auditing; required • Demonstrated proficiency in medical record auditing and ICD-10 CM, ICD-10-PCS, APC, ASC, HCPCS, and CPT coding methodology. • Demonstrated proficiency in computer skills and typing, i.e., Microsoft Windows, Outlook, Excel, Word, PowerPoint, Internet browsers and in virtual meeting tools i.e., Microsoft Teams, Zoom, etc.

🏖️ Benefits

• Benefits on first day of employment • generous, flexible vacation policy • 401(k) employer match • comprehensive health benefits • educational assistance • variety of leadership and technical development academies

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