Senior Associate, Coding Auditor

🕒 August 26

🤠 Texas – Remote

🤠 Texas – Remote

💵 $54.1k - $77.3k / year

⏰ Full Time

🟠 Senior

🔎 Auditor

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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, 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 • Cross-train to perform reviews of multiple claim types • Assist management with training new Coding Auditors through daily monitoring, mentoring, feedback, and education • Maintain current knowledge of coding guidelines • Attend training and scheduled meetings to enhance clinical policy, procedure, rule, and regulation knowledge

🎯 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 • Demonstrated proficiency in ICD-10-CM, ICD-10-PCS, APC, ASC, HCPCS, and CPT coding methodology • Thorough understanding of APR-DRG, AP-DRG, and MS-DRG • Demonstrated experience in medical record coding and auditing • Ability to maintain coding certification through required CEUs • Must work remotely from within the United States

🏖️ Benefits

• Flexible hours • Work-life balance • Continuous learning and career development • Benefits on first day of employment • Remote work from home • Generous, flexible vacation policy • 401(k) employer match • Comprehensive health benefits • Educational assistance • Leadership and technical development academies • Training and leadership opportunities • Career advancement opportunities