Senior Associate, Coding Auditor

🕒 August 26

🇺🇸 United States – Remote

💵 $54.1k - $77.3k / year

⏰ Full Time

🟠 Senior

🔎 Auditor

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 51%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.Why this score:

• Open for 80 days.
• Jobs at this company usually fill in 22 days.
• Reposted 2 times.

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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 audits of medical record documentation to determine the accuracy of principal and secondary diagnosis, including MCC and CC, and procedure codes • Adhere to official coding guidelines, coding clinics, and regulatory guidelines and mandates • Apply advanced ICD-10 coding expertise to substantiate conclusions • Use HMS proprietary auditing systems to document audit determinations and rationale • Consistently achieve productivity and quality performance standards established by management • Cross-train to perform reviews of multiple claim types and provide a flexible workforce to meet client needs • Assist management with training new Coding Auditors through daily monitoring, mentoring, feedback, and education • Maintain current knowledge of coding guidelines and complete required CEUs to maintain coding certification • Attend training and scheduled meetings to enhance skills and working knowledge of clinical policies, procedures, rules, and regulations

🎯 Requirements

• 1+ years active professional credentials through AHIMA or AAPC: CPC, CCS, COC, RHIA, RHIT; required • 3+ years coding inpatient or outpatient claims; required • Demonstrated proficiency in medical record auditing and ICD-10 CM, ICD-10-PCS, APC, ASC, HCPCS, and CPT coding methodology • Demonstrates a thorough understanding of the APR-DRG, AP-DRG, and MS-DRG • Demonstrated experience in medical record coding and auditing

🏖️ Benefits

• Flexible hours • Work-life balance • Continuous learning and career development • Remote (work from home) environment within the United States • Benefits on first day of employment • Clear path to advancement with training and leadership • Generous, flexible vacation policy • 401(k) employer match • Comprehensive health benefits • Educational assistance • Leadership and technical development academies

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