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
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
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 sick leave and paid vacation
What you’ll be doing:
and accurately conduct coding reviews on medical records for assigned client
audit contract while meeting compliance, productivity and quality expectations.
refer reviews for clinical validation.
update all contract and/or review findings a supporting documentation into the
audit processing system.
logic/parameters for system edits to detect incorrect coding over payments,
aberrant and abusive coding patterns.
concept development and data analysis of reports for potential edit
and major payer coding and reimbursement policies.
identifying new issues for audit, perform research to validate new issues, and
provide new rules, regulations and applicable Medicare or program language and
current knowledge of all Medicare and Commercial regulations, policies and procedures.
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.
maintain professional working relationships within the department and
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.
developing material for training and facilitate or assist in MS-DRG audit
educating Performant team members on coding, policies, regulations, appeal
strategies, etc. as needed.
conference calls and meetings as requested.
Performant’s company core values as a member of the team in performing one’s
respect for others, diversity and professionalism in communications and conduct
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.
commitment to compliance, quality and achievement of business goals and results
for our clients and for our business.
miscellaneous duties as assigned required to meet business needs in a highly
What you offer:
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
2+ years of
direct experience in medical chart review for all provider/claim types for
inpatient/outpatient and coding/auditing facility outpatient services
experience desirable in either a provider or payer environment
experience in a claim processing, edit development, and/or coding and
reimbursement policy a plus.
of CMS rules and regulations
the use of MCS 1500/UB 04 forms
working knowledge of CPT/HCPCs/ICD-9/ICD-10, MS-DRG coding and encoder.
to review, analyze, and research coding issues
policy and/or claims software analyst experience
with interpreting electronic medical records (EHR)
understanding of accounting principles for accounts payable and receivable as
it relates to medical billing
professional, and respectful attitude
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
multi-task effectively and work independently in a remote setting
written and verbal communication skills
comfortable navigating and using desktop technology, as well as working
knowledge of MS Office applications (Outlook, Word, Excel).
submit to and pass background check and drug screen.
not have any Federal or State liens resulting from County, State or Federal tax
not have any current defaulted student loans.
be able to pass a criminal background check
be able to pass additional background and/or clearance per Federal contract
acceptable home internet connection and meet requirements of Performant
Teleworking Policies for remote work eligibility based on consideration of
Join our team
To view the full job description and apply, go to: http://careers.performantcorp.com
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.
SUBMISSIONS WITHOUT A PRIOR STAFFING AGREEMENT AND JOB ORDER