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Inpatient Auditing Specialist FT

Remote · Philippines Full-time

As an Inpatient Auditing Specialist,you will be instrumental in addressing consulting and educational needs related to coding quality, compliance assessments, external payer reviews, coding education, and coding workflow operations reviews. In this role, you will offer meaningful information tailored to exceed customer expectations, actively identifying and presenting solutions for customer issues. This role is fully remote with a flexible schedule, allowing you to help shape the future of healthcare from your own workspace! Preferred: Seeking an experienced Inpatient Auditing Specialist with a minimum of three years of auditing experience. The ideal candidate will be proficient in conducting rebill second-level reviews, including cases involving myocardial infarction (MI), cerebrovascular accidents (CVA), mortality reviews, query validation, and HAC/PSI analysis. In addition to strong auditing expertise, this role requires an educational component, as the specialist will be expected to provide guidance and answer coding-related questions to support coder development and ensure quality and compliance. Experience with Dolbey Fusion and Trucode is preferred. What You Will Do:

  • Performs Inpatient Facility coding audits according to scope of work, for the purpose of Onboarding, Focused, Service Level Agreements or Other Types of reviews, using appropriate assignment of codes and other coding-related elements using MS DRG or APR DRGs.
  • Provides rich and concise rationale explaining the reasoning behind any identified changes, including specific references, location of documentation, etc.
  • Keeps abreast of regulatory changes.
  • Organizes and prioritizes multiple cases concurrently to ensure optimal workflow and turnaround time
  • Provides coder education via the auditing process
  • 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.
  • High complexity of work function and decision making
  • Strong organizational, teamwork, and leadership skills

Preferred: Seeking an experienced Inpatient Auditing Specialist with a minimum of three years of auditing experience. The ideal candidate will be proficient in conducting rebill second-level reviews, including cases involving myocardial infarction (MI), cerebrovascular accidents (CVA), mortality reviews, query validation, and HAC/PSI analysis. In addition to strong auditing expertise, this role requires an educational component, as the specialist will be expected to provide guidance and answer coding-related questions to support coder development and ensure quality and compliance. Experience with Dolbey Fusion and Trucode is preferred. What You Need to Succeed:

  • 5+ years of facility inpatient coding experience and/or auditing.
  • CCS (preferred), RHIA or RHIT preferred
  • Maintain 95% DRG accuracy rate
  • Experience with various software including Epic, Cerner, and other prevalent EMRs.

What We Offer:

  • Benefits for Full-Time employees: Medical, Dental, Vision, 401k Savings Plan w/match, 2 weeks of paid time off, and Paid Holidays, Floating Holidays
  • Free CEUs every year
  • Stipend provided to assist with education and professional dues (AHIMA/AAPC) If Applicable
  • Equipment: monitor, laptop, mouse, headset, and keyboard
  • Comprehensive training led by a credentialed professional coding manager
  • Exceptional service-style management and mentorship (we're in this together!)

Pay ranges for this job title may differ based on location, responsibilities, skills, experience, and other requirements of the role. Pay ranges for this job title may differ based on location, responsibilities, skills, experience, and other requirements of the role. The estimated base pay range per hour for this role is: $35-$45 USD

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