Audit Specialist

🕒 il y a 26 jours

🇺🇸 États-Unis – Télétravail

💵 $50 - $57 / heure

⏰ Temps Plein

🟡 Intermédiaire

🟠 Senior

🗣️🇺🇸🇬🇧 Anglais requis

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Datavant

201 - 500 employés

Fondée en 2017

🏥 Santé

💼 Conseil

⚕️ Assurance santé

💰 €40 000 000 Series B en 2020-10

Healthcare • Consulting • Healthcare Insurance

Datavant est une entreprise de plateforme de données de santé dédiée à rendre les données de santé mondiales sécurisées, accessibles et exploitables. Elle propose un réseau propriétaire qui facilite la connectivité des données dans l'écosystème de la santé, permettant à plus de 60 millions de dossiers de santé d'être partagés entre plus de 70 000 hôpitaux et un vaste réseau de partenaires de données réelles. En fournissant des solutions pour les régimes de santé, les prestataires de soins de santé et les sciences de la vie, Datavant joue un rôle essentiel dans l'amélioration des soins aux patients et la réalisation d'analyses dans le secteur de la santé.

Description

• Conduct retrospective and concurrent audits of CDIQ Specialists’ work for accurate documentation review, compliant query generation, and appropriate capture of SOI, ROM, CC/MCC, and HCC • Review missed opportunities affecting reimbursement, quality reporting, and patient outcomes • Collaborate with physicians and caregivers to support appropriate reimbursement and clinical severity for DRG-based payer patients • Evaluate adherence to organizational workflows, policies, and industry standards • Maintain audit tools, scoring methodologies, and audit documentation • Provide individualized feedback and develop education plans based on audit findings • Participate in onboarding and mentoring new CDQI staff • Deliver educational presentations on documentation, coding, regulatory updates, and best practices • Collaborate with the Physician Advisor regarding documentation opportunities and trends • Monitor program performance indicators, including query rates, response rates, agreement rates, accuracy scores, case mix index impact, and CC/MCC capture rates • Safeguard PHI, medical records, audit documentation, and company data in compliance with HIPAA and applicable standards • Complete assigned audits within designated timeframes and produce actionable audit findings and educational feedback

🎯 Exigences

• 5+ years of CDI experience and/or auditing • 3+ years of clinical experience in an academic medical center • RN or BSN with CCDS or CDIP certification • Must pass CDI skills competency assessment • Experience with various EMRs and CDI software including Epic, Cerner, 3M, Iodine, etc. • Ability to function in a professional, efficient, and positive manner • Strong organizational, teamwork and communication skills • Must be located in the United States • This job is not eligible for employment sponsorship

🏖️ Avantages

• Comprehensive health, dental, and vision insurance • 401k Savings plan with match • Paid time off (PTO) plan • Floating holidays and paid holidays • Flexible work arrangements • Opportunities for career growth and development

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