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