Senior Coding Auditor, Itemized Bill Reviewer- Remote
About The Position
It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development. 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.
Requirements
- 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.
Responsibilities
- 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
- Assists management with training new Coding Auditors to include daily monitoring, mentoring, feedback and education.
- Maintains current knowledge of coding guidelines and successfully completes 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
Benefits
- Benefits effective on your first day of employment
- Clear career advancement opportunities with ongoing training and leadership development
- flexible vacation policy
- a 401(k) employer match
- comprehensive health benefits
- educational assistance
- leadership and technical development academies
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
No Education Listed
