Employer Industry: Healthcare Auditing

Why consider this job opportunity:
- Salary up to $45.67 per hour ($95,000 annualized)
- Eligible for discretionary bonus consideration
- Comprehensive benefits package, including medical, dental, vision, disability, and life insurance
- 401(k) savings plan and paid family leave
- Generous Paid Time Off (PTO) ranging from 17-27 days per year based on service length
- Opportunity to work remotely

What to Expect (Job Responsibilities):
- Analyze and audit inpatient claims, ensuring compliance with coding principles and clinical guidelines
- Utilize proprietary auditing systems proficiently to make audit determinations and generate audit letters
- Meet or exceed productivity and accuracy standards set by the audit operations management team
- Identify potential claims outside existing concepts for additional recoveries and suggest process improvements
- Complete all responsibilities as outlined in the annual Performance Plan and assist with special projects as assigned

What is Required (Qualifications):
- Associate or bachelor's degree in nursing (active/unrestricted license) or in Health Information Management (RHIA or RHIT)
- Coding/CDI certification (RHIA, RHIT, CPC, CCS, CIC, CDIP, or CCDS) required and must be maintained
- 5 to 7+ years of experience with ICD-9/10CM, MS-DRG, AP-DRG, and APR-DRG
- Expert knowledge of coding guidelines, medical claims billing/payment systems, and payer reimbursement policies
- Proficiency in Word, Access, Excel, TEAMS, and excellent written and verbal communication skills

How to Stand Out (Preferred Qualifications):
- Experience with official coding guidelines and regulatory compliance
- Working knowledge of industry-based standards and coding clinic determinations
- Strong analytical skills and attention to detail
- Ability to communicate effectively in a team-oriented environment

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