About Us:
Our purpose is to help clients exceed their financial health goals. Across the
reimbursement cycle, our scalable solutions and clinical expertise help solve
programmatic needs. Enabling our teams with leading technology allows analytics
to guide our solutions and keeps us accountable achieving goals.
We build long-term careers by investing in YOU. We seek to create an environment
that cultivates your professional development and personal growth, as we believe
your success is our success.
JOB SUMMARY:
Serves in a consulting role by evaluating the work of client’s coders in their
assignment of ICD-10, CPT and/or HCPCS codes to hospital inpatient, outpatient
and/or physician practice encounters. Performs concurrent or retrospective
reviews to inventory code assignments and report the data to the client.
Develops and delivers educational content to clients related to audit findings.
Must have extensive IP facility and/or OPP facility coding and auditing
experience
Must have AHIMA or AAPC certification - CCS, RHIT, RHIA strongly preferred, will
consider CIC or COC
This is a remote position
ESSENTIAL DUTIES AND RESPONSIBILITIES:
Note: The essential duties and responsibilities below are intended to describe
the general duties and responsibilities of this position and are not intended to
be an exhaustive statement of duties. This position may perform all or most of
the primary duties listed below. Specific tasks, responsibilities or
competencies may be documented in the Team Member’s performance objectives as
outlined by the Team Member’s immediate Leadership Team Member.
Perform complex concurrent and/or retrospective analysis of inpatient medical
record documentation to validate coded data in accordance with AHA, CMS,
AHIMA, Coding Clinic, and official ICD-10 guidelines.
Analyze findings and identify potential root causes of produced errors.
Prepare summary reports of findings to clients, supplying specific references
supporting findings contained within the provided audit report.
Provides second-level review of processes to ensure compliance with legal and
procedural policies and to ensure appropriate code assignments.
Research, analyze, and respond to inquiries regarding compliance, coding, and
denials.
In all situations, protect the privacy and confidentiality of patient health
and client information, and follow the Standards of Ethical Coding as set
forth by AHIMA and adhere to official coding guidelines and compliance
practices, standards, and procedures.
Functions as a member of the Consulting Services Team which develop and
provide coding education to clients.
Conduct Audits as assigned meeting the productivity standards as set by
record type for each audit. The threshold for billable productive hours, when
client work is available, is expected to be at or above 80%.
Prepare deliverables for the client as required for the audit scope while
meeting timelines.
Conduct independent QA of their assigned audit results prior to final
submission for QA review and approval. The minimum accuracy expectation is
95%.
Report work time and work products in a timely and accurate manner.
Communicates with coworkers in an open and respectful manner that promotes
teamwork and knowledge sharing.
Interact with clients in a professional manner that, always, exhibits
excellent relationships, work performance and communication skills so as to
support the company and its business interests.
Provide schedule of planned work activities, events and sites, and any
changes to same, to Management and appropriate staff.
Maintenance of professional credentials and knowledge of coding,
reimbursement, and compliance issues through continuing education.
Periodic travel, as applicable.
Other duties and responsibilities, as assigned.
Knowledge, Skills & Abilities:
Recognized credential from AHIMA or AAPC.
Experience with telecommuting and electronic medical record systems required.
Strong analytical skills.
Proficient computer skills, specifically Microsoft Office products.
Strong team player.
Ability to work with multiple and diverse clients and projects.
Ability to work with minimal supervision.
Ability to maintain and access multiple files.
Assure that work product is completed with high levels of accuracy and
attention to detail.
5+ years’ experience coding and/or auditing in an acute care facility or
clinic, of patient types listed in the Job Summary of this document, or other
relevant experience.
This is a remote position
PHYSICAL DEMANDS:
Note: Reasonable accommodations may be made to enable individuals with
disabilities to perform the essential functions as described. Regular eye-hand
coordination and manual dexterity is required to operate office equipment. The
ability to perform work at a computer terminal for 6-8 hours a day and function
in an environment with constant interruptions is required. At times, Team
Members are subject to sitting for prolonged periods. Infrequently, Team Member
must be able to lift and move material weighing up to 20 lbs. Team Member may
experience elevated levels of stress during periods of increased activity and
with work entailing multiple deadlines.
A job description is only intended as a guideline and is only part of the Team
Member’s function. The company has reviewed this job description to ensure that
the essential functions and basic duties have been included. It is not intended
to be construed as an exhaustive list of all functions, responsibilities, skills
and abilities. Additional functions and requirements may be assigned by
supervisors as deemed appropriate.