Outpatient Coding Auditor

🔥 0 minutes ago

🤠 Texas – Remote

🤠 Texas – Remote

💵 $70k - $80k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

🔎 Auditor

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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Gainwell Technologies

WebsiteLinkedInAll Job Openings

10,000+ employees

💼 Consulting

📦 Logistics

⚕️ Healthcare Insurance

💰 Grant on 2023-06

Consulting • Logistics • Healthcare Insurance

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

• Perform coding reviews and audits of medical records and other documentation to determine correct coding • Determine the accuracy of principal and secondary diagnoses, including MCC and CC, and procedure codes • Adhere to official coding guidelines, coding clinics, regulatory guidelines, and mandates • Apply advanced ICD-10 coding expertise to substantiate conclusions • Use proprietary auditing systems to document audit determinations and rationale • Consistently achieve productivity and quality performance standards • Cross-train to perform reviews of multiple claim types • Assist management with training new Coding Auditors through monitoring, mentoring, feedback, and education • Attend training and scheduled meetings to enhance clinical policy, procedure, rule, and regulation knowledge

🎯 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 • Demonstrated proficiency in ICD-10-CM, ICD-10-PCS, APC, ASC, HCPCS, and CPT coding methodology • Demonstrated proficiency in Microsoft Windows, Outlook, Excel, Word, PowerPoint, Internet browsers, and virtual meeting tools including Microsoft Teams and Zoom • Extensive background in outpatient coding edits • High level of understanding of reimbursement guidelines, specifically EAPG, ASC, and APC payment systems • Ability to maintain coding certification through required CEUs

🏖️ Benefits

• Benefits on first day of employment • Clear path to advancement with training and leadership • Flexible vacation policy • 401(k) employer match • Comprehensive health benefits • Educational assistance • Leadership and technical development academies • Work flexibility • Learning and career development opportunities