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Inpatient DRG Coding Auditor II (SCA) Job in Remote San Angelo TX, Texas

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Job Title: Inpatient DRG Coding Auditor II (SCA)

Employer:Performant Financial
Type:Full-Time
Skills:Coding,auditing,MS Word,MS Excel
Specialties:physician’s office or other acute facility setting (inpatient/SNF Facility), DRG coding for hospital
Required Certifications:or CCS-P,RHIA,CPC-H,CPC-P,CPC,RHIT,CCS
Required Experience:3 to 4 years
Location:Remote San Angelo TX, TX
Date Posted:6/12/2019

Explore Performant Careers!       

Performant Financial is a market leader providing technology workflow management solutions for various government, healthcare, and financial services markets. We focus on audit and recovery services through our technology platform, combined with robust analytics and experience gathered through decades of proven success. If you are ready to use your strengths in medical coding and auditing and  have a keen eye for identifying issues, and passion for excellence in a new way, then this Inpatient DRG Coding Auditor II role is for you!

As a member of our medical audit team, the Inpatient DRG Coding Auditor II will have an opportunity to make a direct contribution to the company’s bottom line in our rapidly growing healthcare business. You will leverage your ICD10/DRG coding knowledge, and medical claims experience from inpatient and outpatient settings, to identify client records with billing coding issues and recovery opportunities.

 

We offer: 

·         A competitive benefits package

·         Core health benefits- Medical, Dental and Vision

·         Company-paid Life and AD&D

·         Other health benefit programs include supplemental Life, AD&D, short-term and long-term disability,

·         Accident and Critical Illness, Identity Theft, and Flexible Spending Accounts

·         Employee Assistance Plan

·         Health Advocate Services

·         Beyond Work discount products and services

·         Paid holidays

·         Paid sick leave and paid vacation

·         401K program

What you’ll be doing:

·         Objectively and accurately conduct coding reviews on medical records for assigned client audit contract while meeting compliance, productivity and quality expectations.

·         Appropriately refer reviews for clinical validation.

·         Enter and update all contract and/or review findings a supporting documentation into the audit processing system.

·         Write logic/parameters for system edits to detect incorrect coding over payments, aberrant and abusive coding patterns.

·         Proof of concept development and data analysis of reports for potential edit development.

·         Monitor CMS and major payer coding and reimbursement policies.

·         Assist in identifying new issues for audit, perform research to validate new issues, and provide new rules, regulations and applicable Medicare or program language and explanation.

·         Maintain a current knowledge of all Medicare and Commercial  regulations, policies and procedures.

·         Maintain certifications and training required to ensure eligibility to perform audits on behalf of Performant such as coding certification(s), as well as HIPPA and other compliance training provided by Performant.

·         Develop and maintain professional working relationships within the department and cross-functionally.

·         Notify management of: all correspondence indicating displeasure with the RA, in the over payment identification, or in the recovery methods utilized, or legal action, or government intervention.

·         Assist in developing material for training and facilitate or assist in MS-DRG audit training sessions.

·         Assist in educating Performant team members on coding, policies, regulations, appeal strategies, etc. as needed.

·         Attend conference calls and meetings as requested.

·         Demonstrate Performant’s company core values as a member of the team in performing one’s role:

o   People – respect for others, diversity and professionalism in communications and conduct

o   Innovation – adaptability, and flexibility in applying skills in our dynamic business environment. Creativity and open minded in solving issues in our  teams, in development and delivery of our products, and for our clients.

o   Excellence – commitment to compliance, quality and achievement of business goals and results for our clients and for our business.

·         Perform miscellaneous duties as assigned required to meet business needs in a highly professional manner.

What you offer:

·         Certification as a CPC, CPC-H, CPC-P, RHIA, RHIT, CCS, or CCS-P

·         3+ years of DRG coding for hospital, physician’s office or other acute facility setting (inpatient/SNF Facility)

·         2+ years of direct experience in medical chart review for all provider/claim types for inpatient/outpatient and coding/auditing facility outpatient services

·         Prior auditing experience desirable in either a provider or payer environment

·         Previous payer experience in a claim processing, edit development, and/or coding and reimbursement policy a plus.

·         Possess knowledge of CMS rules and regulations

·         Proficient in the use of MCS 1500/UB 04 forms

·         Thorough working knowledge of CPT/HCPCs/ICD-9/ICD-10, MS-DRG coding and encoder.

·         Proven ability to review, analyze, and research coding issues

·         Reimbursement policy and/or claims software analyst experience

·         Familiarity with interpreting electronic medical records (EHR)

·         Basic understanding of accounting principles for accounts payable and receivable as it relates to medical billing

·         Courteous, professional, and respectful attitude

·         Adaptability of skills to handle any non-standard situations that may arise or apply skills in new ways as may be required to meet business needs

·         Ability to multi-task effectively and work independently in a remote setting

·         Attention to detail

·         Excellent written and verbal communication skills

·         Typing skills, comfortable navigating and using desktop technology, as well as working knowledge of MS Office applications (Outlook, Word, Excel).

 

Other Requirements:

·         Must submit to and pass background check and drug screen.

·         Must not have any Federal or State liens resulting from County, State or Federal tax issues. 

·         Must not have any current defaulted student loans.

·         Must be able to pass a criminal background check

·         Must be able to pass additional background and/or clearance per Federal contract assignments.

·         Must have acceptable home internet connection and meet requirements of Performant Teleworking Policies for remote work eligibility based on consideration of remote location.

 

Join our team today!

To view the full job description and apply, go to: http://careers.performantcorp.com

 

Performant Financial Corporation is an Equal Opportunity Employer/Affirmative Action Employer. Performant Financial Corporation is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, age, religion, gender, gender identity, sexual orientation, pregnancy, age, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law.

 

NO AGENCY SUBMISSIONS WITHOUT A PRIOR STAFFING AGREEMENT AND JOB ORDER


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