- Conduct outpatient coding audits on medical records, utilizing ICD-10-CM, CPT, and appropriate coding references for accurate DRG and APC assignment.
- Review non-CC/MCC records to assess proper coding or identify the need for additional documentation. Scrutinizes all HCPCS and CPT codes influencing APC assignment.
- Provide coder education through the auditing process.
- Prepare preliminary results for review by the facility or CCS HIM director.
- Review disagreements on APC/DRG changes with the appropriate manager.
- Prepare the final reports for the coding audit and actively participates in the resolution of audit findings.
- Provide coder education via email and/or conference calls, utilizing the audit spreadsheet findings and comments.
- Attend coding workshops as necessary.
- Stay current with regulatory changes.
- Organize and prioritize multiple cases concurrently to ensure departmental workflow and prompt case resolution.
- Demonstrate versatility and exceptional work across a wide range of coded services.
- Meet with client facility representatives to discuss issues and trends identified in audits.
- Develop and implement education for physicians, nursing, and other clinical staff to enhance documentation.
- Communicate effectively with co-workers, management, and hospital staff regarding clinical and reimbursement issues.
- Function in a professional, efficient, and positive manner.
- Adhere to the American Health Information Management Association's code of ethics.
- Maintain a customer-service focus and exhibits professionalism, flexibility, dependability, a desire to learn, commitment to excellence, and commitment to the profession.
- Conduct audits on external coding staff as needed and provides reports to the manager as directed.
- Handle a high complexity of work functions and decision-making.
- Demonstrate strong organizational, teamwork, and leadership skills.
- 3+ years experience coding and auditing
- Associate or Bachelor's degree from an AHIMA-certified HIM or Nursing Program, or completion of a certificate program from AAPC with a preference for CCS
- Prefered: CCS, RHIT, or RHIA credentials.
- Recent experience in academic/level 1 trauma centers
- Experience coding and auditing inpatient and outpatient records for various facilities
- Track record of acceptable productivity standards
- Maintain 95% accuracy rate for APC assignment and 95% productivity rate
- Experience with various software including EMR, Encoder and Auditing software
- Perks: 401k Savings Plan
- 20-24 free CEUs per year, provided by Datavant
- AAPC/AHIMA dues compensation
- Company equipment will be provided to you (including computer, monitor, etc.)
- Comprehensive training lead by a hiring manager
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Outpatient Audit Specialist - Remote, United States - CIOX
Description
OverviewDatavant protects, connects, and delivers the world's health data to power better decisions and advance human health.
We are a data logistics company for healthcare whose products and solutions enable organizations to move and connect data securely.
Datavant has a network of networks consisting of thousands of organizations, more than 70,000 hospitals and clinics, 70% of the 100 largest health systems, and an ecosystem of 500+ real-world data partners.
By joining Datavant today, you're stepping onto a highly collaborative, remote-first team that is passionate about creating transformative change in healthcare.
We hire for three traits:
we want people who are smart, nice, and get things done.
We invest in our people and believe in hiring for high-potential and humble individuals who can rapidly grow their responsibilities as the company scales.
Datavant is a distributed, remote-first team, and we empower Datavanters to shape their working environment in a way that suits their needs.
As an Outpatient Auditing Specialist (PRN) you will be instrumental in addressing consulting and educational needs related to coding quality, compliance assessments, external payer reviews, coding education, interim coding management, and coding workflow operations reviews.
In this role, you will offer meaningful information tailored to exceed customer expectations, actively identifying and presenting solutions for customer issues.
This role is fully remote with a flexible schedule, allowing you to help shape the future of healthcare from your own workspaceResponsibilities
To ensure the safety of patients and staff, many of our clients require post-offer health screenings and proof and/or completion of various vaccinations such as the flu shot, Tdap, COVID-19, etc.
Any requests to be exempted from these requirements will be reviewed by Datavant Human Resources and determined on a case-by-case basis.
Depending on the state in which you will be working, exemptions may be available on the basis of disability, medical contraindications to the vaccine or any of its components, pregnancy or pregnancy-related medical conditions, and/or religion.
This position requires that you provide a high-speed internet connection, subject to applicable expense reimbursement requirements (if any), and a work environment free from distractions.
Pay ranges for this job title may differ based on location, responsibilities, skills, experience, and other requirements of the role.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
$ $40.00 per hour
