Audit Specialist

🔥 5 minutes ago

🇺🇸 United States – Remote

💵 $50 - $57 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 4%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Datavant

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2017

🏥 Healthcare

💼 Consulting

⚕️ Healthcare Insurance

💰 $40M Series B on 2020-10

Healthcare • Consulting • Healthcare Insurance

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 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

🎯 Requirements

• 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

🏖️ Benefits

• 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