Specialist, Coding Audit, Compliance & Education - Inpatient Auditor

AcclaraRemote, United States


Description

Hey there! We’re Acclara.

As a remote-first workforce with team members in all 50 states, we’re a unique group of strategists, technologists, and service providers—all united in serving our partners to deliver the best care to their patients, helping build even healthier communities for us all to live and work in.

We bring our one-of-a-kind selves to work each day, and we welcome (and want) you to do the same. Coffee connoisseurs, moms and dads, runners, animal lovers, adventurists—the list goes on—we all came to make a difference, and we stay because we’ve found a place where we don’t have to do it alone.

Our team’s work is fueled by our CORE values of Commitment, Outcomes, Respect, and Empowerment. They’re the “how” behind what we do, guiding our actions as we aim to change the way technology and services come together.

The Role

The Inpatient Coding Auditor, Compliance and Education Specialist is responsible for performing retrospective and prospective compliance reviews of medical coding related to specialized types of coding, such as inpatient/DRG, interventional radiology, cardiothoracic surgery, and other types of specialized coding.  The role includes delivering findings and education based on documentation requirements both verbally and in writing to the client as well as the coder(s).    

What You’ll Do

  • Responsible for auditing coded accounts to ensure appropriate selection of codes.  This may include principal or first listed diagnosis, secondary diagnosis codes, ICD-10-PCS for inpatient coding, CPT procedure codes for outpatient coding, evaluation, and management codes, HCPCS and modifiers as well as appropriate sequencing of diagnostic codes.  Validation of certain data abstraction elements may also be included, such as admission type, discharge disposition, etc.    
  • Responsible for conducting documentation audits and preparing resulting reports, including national comparative data as it relates to the clients individually or aggregately   
  • Responsible for creating, maintaining, and delivering educational content for clients and coders to support documentation improvement or understanding as it relates to coding, ensuring documentation meets coding guidelines and the standards of ethical coding; specialty and service line specific coding and reimbursement topics and completing administrative activities required to deliver education   
  • Responsible for researching, reviewing, and interpreting payer guidelines   
  • Performs validation reviews for coding quality, accuracy, and compliance   
  • Provides written feedback and/or one on one recommendations for clients, providers and coding staff related to documentation and coding guidelines   
  • Prepares audit reports for presentation   
  • Prepares resource material for education, including tip sheets and coding resources   
  • Abides by the Standards of Ethical Coding and adheres to official coding guidelines   
  • Responsible for researching education topics and/or opportunities for clients on coding and reimbursement issues and updates and completing administrative activities required to deliver education   
  • Other duties as assigned   

What We’re Looking For

  • High School Diploma or equivalent   
  • 7 years medical coding and/or auditing experience in specialized type of medical coding, such as inpatient/DRG, interventional radiology, cardiothoracic surgery, etc.   
  • 2 years’ experience in adult learning and education.  Examples may include providing physician education, coder education, college-level instruction, etc.    
  • Ability to visually present educational content in applications such as Microsoft PowerPoint and Word.   
  • An active nationally recognized medical coding credential through AHIMA/AAPC: CPMA, CPC, COC, CCS, CCS-P, RHIA or RHIT     
  • Excellent oral and written communication skills to effectively interact with and communicate with clients.   
  • Strong experience working with PowerPoint, Excel, and Adobe.   
  • Understanding of all or a combination of ICD-10-CM and PCS, CPT, HCPCS, medical terminology, Anatomy and Physiology and HIPAA Compliance     
  • Ability to consistently engage and build relationships with internal and external partners.   
  • Self-motivated and resourceful with the ability to multi-task and meet deadlines under time pressures.   
  • Position qualifies for work from home, however, travel to client locations may be required.

How We Take Care of Our Team Members

  • Remote-first workplace, with opportunities to work on-site in certain locations
  • Comprehensive medical, dental, and vision coverage
  • Parental leave
  • 401K with company match
  • Company-paid life insurance, short-term disability, and long-term disability
  • Paid time off and holidays

Pay Range: $25.41 - $42.39

This compensation range is a reasonable estimate that extends from the lowest to the highest pay Acclara in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. Acclara may ultimately pay more or less than the posted range as permitted by law.

Diversity, Equity, and Inclusion Matter

At Acclara, you’re invited to bring more of yourself to work—not less. Your background, your culture, and your personal experiences are all important pieces of the authentic you, and we honor that. Connection is created when we show up.

Acclara, an R1 company, is dedicated to the fundamentals of equal employment opportunity. Acclara’s employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person’s age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, Acclara is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories.

If you need reasonable accommodation due to a disability for any part of the interview process, please contact [email protected].

Visa Sponsorship is not available at this time.