Senior Coding Auditor, Itemized Bill Reviewer

🕒 September 9

🎸 Tennessee – Remote

🎸 Tennessee – Remote

💵 $70k - $80k / year

⏰ Full Time

🟠 Senior

🔎 Auditor

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 24%

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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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 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 • Achieve 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 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, 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 • Working knowledge of hospital billing and charging, including UB-04s, itemized bills, revenue codes, CPT/HCPCS codes, and ICD-10 diagnosis and procedure codes • Proficiency with Microsoft Windows, Outlook, Excel, Word, PowerPoint, internet browsers, Microsoft Teams, Zoom, and similar virtual meeting tools • Maintain coding certification through required CEUs

🏖️ Benefits

• Benefits effective on your first day of employment • Clear career advancement opportunities • Ongoing training and leadership development • Flexible work hours • Work-life balance • Flexible vacation policy • 401(k) employer match • Comprehensive health benefits • Educational assistance • Leadership and technical development academies • Up to 10% travel