Revenue Integrity Coding Auditor Location : Remote / Hybrid - Open to All States
Travel Requirement : Must be willing to travel to Arkansas for orientation (travel expenses likely self-funded). Suggested to stay close to the orientation location.
Salary : $75,000 - $90,000 Base
Position Summary We are seeking a highly skilled and experienced Revenue Integrity Coding Auditor to join our dynamic team. The ideal candidate will possess a Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) certification and have a minimum of 3 years of Inpatient and / or Outpatient coding experience. This role is crucial in ensuring accurate coding, MS-DRG assignment, and compliance within our healthcare organization.
Work Schedule
- Full-time : 40 hours per week
- Monday - Friday
Primary Duties Review Activities :
Conduct reviews of Clinical Documentation Improvement (CDI) mismatches.Evaluate responses to late query submissions.Assess Besler quality recommendations.Examine coding issues related to medical necessity and other concerns.Investigate MS-DRG denials.Conduct coding compliance research.Perform RVU analysis.Review high-risk cases (e.g., Impella, TCAR, Aveir DR).Handle rebill requests.Address discharge not final billed (DNFB) reports.Provide continued support for charge review.Collaboration :
Work closely with providers, clinical, coding, and CDI team members.Respond to coding questions and collaborate with the CDI QA team on DRG reconciliation.Collaborate with the Director of HIM / Coding / Billing on coding quality and education recommendations.Auditing and Reporting :
Perform random and focused medical records reviews for accurate coding and MS-DRG assignment.Summarize audit findings and provide feedback to the Director.Maintain detailed records of audits, results, recommendations, and follow-up actions.Training and Education :
Assist in the training of new coding team members.Contribute to educational activities for all coding team members.Educate providers on coding updates, documentation standards, and summary reviews.External Audits :
Review and respond to third-party coding audits / reviews.Benefits The successful candidate will help enhance the organization's efficiency by :
Increasing efficiency in coding processes.Reducing Days Not Final Billed (DNFB).Decreasing Accounts Receivable (AR) days.Providing research support for coding and RVU-related questions.Improving cash flow.Note : This job description is subject to change as the needs of the organization evolve.
Qualifications / Specifications
Education : High School diploma or equivalent required.Licensure / Certification : Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) certification required.Experience : Minimum of three years of experience in medical coding with ICD-10 and CPT coding systems required. Detail-oriented and experienced coding professional with a passion for ensuring accuracy and compliance.
Salary : $75,000 - $90,000
