MEInpatient Coding Enterprise Auditor- Remote
Med-Metrix is a leader in Revenue Cycle Management (RCM), providing healthcare organizations with cutting-edge technology and personalized service to enhance patient experiences and maximize revenue collections.
The Inpatient Coding Enterprise Auditor is an experienced auditor and certified professional coder with extensive knowledge of inpatient coding and auditing for various specialties, dedicated to ensuring the highest standards of coding accuracy and compliance. This position is critical for maintaining the integrity of coded data and the associated reimbursement. The ideal candidate will possess advanced knowledge of MS and APR grouping methodologies with exceptional attention to detail, and the ability to collaborate effectively with various internal teams to drive continuous improvement in coding practices. The performance of data analytics on coded data is required to identify trends and patterns in coding errors.
Job Purpose
• Collaborate with internal staff to enhance documentation, coding, and compliance.
• Review and assess coding quality on accounts completed by Medical Coders.
• Review clinical documentation to ensure it supports the codes assigned and meets necessary documentation standards.
• Ensure adherence to workflows and ethical coding standards.
• Utilize advanced knowledge of ICD-10-CM and ICD-10-PCS coding concepts.
• Communicate review findings and recommendations to management.
• Assess risk and obtain necessary statistics for coding areas.
Duties and Responsibilities
• Administer the Quality Monitoring Program to meet quality standards and targets.
• Manage daily operational processes for quality, efficiency, and productivity.
• Utilize data analytics to identify trends and patterns in coding errors, proactively addressing issues and improving overall coding quality.
• Collaborate with workgroups to resolve customer-impacting issues.
• Seek continuous improvement and development opportunities for the team.
• Address complaints, questions, and queries as necessary.
• Document team members’ performance and targets.
• Monitor systems for optimal performance.
• Stay updated on guideline changes, laws, and regulations affecting documentation and reimbursement.
• Promote teamwork and service excellence within the department.
• Participate in performance improvement activities.
• Establish and maintain a formalized review process for compliance with contractual agreements on accuracy rates.
Specific Job Functions
• Recommend strategies to achieve high compliance with quality management plans.
• Participate in calls/meetings to address performance and training improvements.
• Assist in training sessions for new hires and provide refresher trainings as needed.
• Ensure compliance with all Med-Metrix policies and procedures.
• Identify high-risk areas in coding and develop strategies to mitigate these risks.
• Provide feedback to management on potential problems and improvement areas.
• Demonstrate exceptional attention to detail and accuracy in reviewing and analyzing medical records.
• Possess strong analytical skills to identify trends, patterns, and areas for improvement in coding practices.
• Handle patients' protected health information (PHI) in compliance with HIPAA standards.
• Ability to prioritize work and remain calm under pressure.
Qualifications
• Hold AAPC and/or AHIMA certification, with CPMA being advantageous.
• Minimum of 3-5 years of Coding and auditing.
◦ Equivalent work experience may be considered in lieu of professional credentials
• Demonstrated knowledge of HIPAA in Medical Coding.
• Demonstrated knowledge and understanding of professional reference materials, such as Coding Guidelines and Coding Clinic
• Proficiency with Microsoft Word, Outlook, Excel and PowerPoint
• Must be able to use job related software
• Ability to work in a team environment and adapt to changing responsibilities.
• Strong verbal, written communication, interpersonal, and analytical skills.
• Self-starter capable of working independently and within a team.
Working Conditions
• Physical Demands: Occasionally move around the work area, sit, perform manual tasks, operate office equipment, extend arms, kneel, talk, and hear.
• Mental Demands: Follow directions, collaborate with others, and handle stress.
• Work Environment: Typically, minimal noise level.
This role is vital for ensuring the accuracy and compliance of coding practices, supporting the organization's goals for high-quality documentation and reimbursement processes.
#cb
Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.
Apply now
Please let Med-Metrix know you found this job on Himalayas. This helps us grow!
About the job
Apply before
Posted on
Job type
Full Time
Experience level
Mid-level
Location requirements
Hiring timezones
United States +/- 0 hoursAbout Med-Metrix
Learn more about Med-Metrix and their company culture.
Med-Metrix delivers innovative solutions that transform the landscape of Revenue Cycle Management (RCM) in the healthcare sector. Founded in 2010, the company has achieved substantial growth by acquiring multiple brands, showcasing its commitment to comprehensive end-to-end RCM services. As operators and industry leaders, Med-Metrix prioritizes collaboration, striving to co-own the revenue challenges, goals, and outcomes of its clients. The company emphasizes a unique hands-on approach, ensuring that each engagement leads to improved results and high accountability.
With a focus on cutting-edge technology and a highly trained workforce, Med-Metrix utilizes advanced analytics, artificial intelligence, and robotic process automation to enhance its service offerings. The company integrates its systems seamlessly with existing EMRs to provide tailored solutions that maximize revenue for healthcare providers—be they hospital systems or physician groups. Known for overturning 60-70% of denials on average through effective Denials Management, Med-Metrix's results-oriented approach enables clients to collect 2-5% more on average for their end-to-end RCM needs. Through initiatives like Med-Metrix University, the company ensures that its professionals are equipped with industry-leading skills, delivering exceptional value and fostering growth in the healthcare industry.
MEMed-Metrix
Company size
1001-5000 employees
Founded in
2010
Chief executive officer
Joseph H. Davi
Markets
Employees live in
Similar remote jobs
Here are other jobs you might want to apply for.
16 remote jobs at Med-Metrix
Explore the variety of open remote roles at Med-Metrix, offering flexible work options across multiple disciplines and skill levels.
Remote companies like Med-Metrix
Find your next opportunity by exploring profiles of companies that are similar to Med-Metrix. Compare culture, benefits, and job openings on Himalayas.
Find your dream job
Sign up now and join over 100,000 remote workers who receive personalized job alerts, curated job matches, and more for free!
