[Hiring] Senior Coding Auditor @Gainwell Technologies LLC

Role Description

We are seeking a talented individual for a Senior Coding Auditor, Itemized Bill Reviewer who is responsible for performing itemized bill review, chart review, and coding validation to ensure that billed services were ordered, allowable, and accurately documented in the patient record. The candidate must have an extensive background in inpatient hospital bill auditing, outpatient facility coding with charge master review.

• Verify that all lines on an itemized bill accurately reflect the services and procedures performed, are covered benefits, were appropriately ordered, properly documented, and reimbursed in accordance with plan policies and provider contract terms.
• Evaluate documentation to ensure accurate coding, charging, and reimbursement for inpatient hospital and outpatient facility services.
• Utilize proprietary auditing systems with a high level of proficiency to document audit findings and rationale.
• Consistently achieve productivity and quality performance standards established by management.
• Actively cross-train to perform reviews of multiple claim types to provide a flexible workforce to meet client needs.
• Assist management with training new Coding Auditors to include daily monitoring, mentoring, feedback, and education.
• Maintain current knowledge of coding guidelines and successfully complete required CEUs to maintain coding certification.
• Responsible for attending training and scheduled meetings to enhance skills and working knowledge of clinical policies, procedures, rules, and regulations.

Qualifications

• One or more active professional credentials through AHIMA or AAPC: CPC, COC, CCS, RHIA, RHIT; required.
• 2+ years experience of inpatient hospital bill auditing, outpatient facility coding with charge master review; strongly preferred.
• Demonstrated proficiency in medical record auditing and ICD-10 CM, ICD-10-PCS, APC, ASC, HCPCS, and CPT coding methodology.
• Strong working knowledge of hospital billing/charging including UB-04’s, itemized bills, revenue codes, CPT/HCPCS codes, ICD10 diagnosis and procedure codes.
• Demonstrated proficiency in computer skills and typing, i.e., Microsoft Windows, Outlook, Excel, Word, PowerPoint, Internet browsers and in virtual meeting tools i.e., Microsoft Teams, Zoom, etc.

Requirements

• 100% Remote Position.
• Up to 10% travel.
• Benefits effective on your first day of employment.
• Clear career advancement opportunities with ongoing training and leadership development.
• The pay range for this position is $70,000.00 - $80,000.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors.

Benefits

• Generous, flexible vacation policy.
• 401(k) employer match.
• Comprehensive health benefits.
• Educational assistance.
• A variety of leadership and technical development academies to help build your skills and capabilities.