Inpatient Audit Specialist - Part Time - REMOTE

Overview

Datavant is a data platform 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.

The Auditing Specialist will play a vital role in addressing consulting and education needs related to coding quality and compliance. Key responsibilities include conducting compliance assessments, facilitating external payer reviews, providing coding education, managing interim coding operations, and reviewing coding workflows. This position requires the ability to deliver meaningful information to meet customer expectations by identifying and proposing effective solutions for customer issues. The ideal candidate will develop and maintain strong account relationships through responsiveness and a calm, reflective approach to work. Collaboration with the Data Quality & Coding Compliance leadership and scheduling teams is essential for achieving optimal service outcomes. We offer a comprehensive benefits package, including a 401(k) savings plan, 20-24 free CEUs per year provided by Ciox, compensation for AAPC/AHIMA dues, company-provided equipment such as a computer and monitor, and comprehensive training led by a hiring manager.

Responsibilities

You Will:

• Performs inpatient and outpatient coding audits medical records and abstracts using ICD-10-CM CPT and appropriate coding references for appropriate DRG and APC assignment.
• Reviews non-CC/MCC records to determine if record was properly coded or if additional
• documentation is needed. Reviews all HCPCS and CPT codes impacting APC assignment
• Provides coder education via the auditing process
• Prepares preliminary results for review by the facility or CCS HIM director
• Reviews APC/DRG change disagreements with appropriate manager
• Prepares the final reports for the coding audit. Participates in settlement of audit findings.
• Provides coder education via email and/or conference call using the audit spreadsheet findings and comments
• Attends coding workshops as necessary
• Keeps abreast of regulatory changes
• Organizes and prioritizes multiple cases concurrently to ensure departmental workflow and case resolution
• Shows versatility and exemplary work including a wide range of services coded
• Meets with client facility representatives to discuss issues and trends identified in audit
• Develops and implements education for physician, nursing, and other clinical staff to improve documentation
• Demonstrate initiative and judgment in performance of job responsibilities
• Communicates 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
• Must be customer-service focused and exhibit professionalism, flexibility, dependability, desire to learn, commitment to excellence and commitment to profession
• Audits external coding staff as needed and provides reports to manager as directed
• High complexity of work function and decision making
• Strong organizational, teamwork, and leadership skills

Qualifications

What you will bring to the table:

• Minimum of 3 years experience coding or auditing
• CCS and RHIA or RHIT credentials preferred
• Recent experience in academic/level 1 trauma centers
• Experience coding or 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.

We are all responsible for stewarding a high-performance culture in which all Datavanters belong and thrive. We are proud to be an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national