Senior Inpatient Coding Auditor

🔥 0 minutes ago

🤠 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 inpatient medical record documentation to determine the accuracy of principal and secondary diagnosis, including MCCs and CCs, and procedure codes • Validate ICD-10 code assignment and sequencing, discharge status, Hospital-Acquired Conditions, POA assignment, and DRG assignment • Adhere to official coding guidelines, Coding Clinic guidance, and regulatory mandates • Use advanced ICD-10 coding expertise to substantiate conclusions • Utilize proprietary auditing systems to document audit determinations 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 • Maintain current knowledge of coding guidelines and complete required CEUs to maintain coding certification • Attend training sessions and scheduled meetings to enhance clinical policy, procedure, rule, and regulation knowledge

🎯 Requirements

• One or more active professional credentials through AHIMA or AAPC (CPC, CCS, COC, RHIA, RHIT); required • 2+ years of experience in inpatient medical record coding and/or auditing; required • Demonstrated proficiency in medical record auditing • Proficiency in ICD-10-CM, ICD-10-PCS, APC, ASC, HCPCS, and CPT coding methodologies • Thorough understanding of APR-DRG, AP-DRG, and MS-DRG • Proficiency in computer skills and typing • Proficiency with Microsoft Windows, Outlook, Excel, Word, PowerPoint, internet browsers, Microsoft Teams, and Zoom • Ability to work remotely within the U.S.

🏖️ Benefits

• Benefits on the first day of employment • Clear path for advancement with training and leadership opportunities • Generous, flexible vacation policy • 401(k) employer match • Comprehensive health benefits • Educational assistance • Leadership and technical development academies • Work flexibility • 0-10% travel