Senior Coding Auditor, Itemized Bill Reviewer

🔥 13 hours ago

🎸 Tennessee – Remote

🎸 Tennessee – Remote

💵 $70k - $80k / 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 itemized bill review, chart review, and coding validation • Verify that itemized bill lines accurately reflect services and procedures performed • Confirm services are covered benefits, appropriately ordered, properly documented, and reimbursed according to plan policies and provider contract terms • Evaluate documentation for accurate coding, charging, and reimbursement for inpatient hospital and outpatient facility services • Use proprietary auditing systems to document audit findings and rationale • Meet productivity and quality performance standards established by management • 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

• One or more active professional credentials through AHIMA or AAPC: CPC, COC, CCS, RHIA, or RHIT; required • 2+ years of experience in inpatient hospital bill auditing and outpatient facility coding with charge master review; strongly preferred • Proficiency in medical record auditing and ICD-10-CM, ICD-10-PCS, APC, ASC, HCPCS, and CPT coding methodology • Strong working knowledge of hospital billing/charging, including UB-04s, itemized bills, revenue codes, CPT/HCPCS codes, and ICD-10 diagnosis and procedure codes • Proficiency in Microsoft Windows, Outlook, Excel, Word, PowerPoint, internet browsers, Microsoft Teams, Zoom, and other virtual meeting tools • Ability to attend training and scheduled meetings • Ability to complete required CEUs to maintain coding certification

🏖️ Benefits

• Benefits effective on your first day of employment • Clear career advancement opportunities with ongoing training and leadership development • 100% remote position • Flexible vacation policy • 401(k) employer match • Comprehensive health benefits • Educational assistance • Leadership and technical development academies • Up to 10% travel