Employer Industry: Healthcare Auditing Services

Why consider this job opportunity:
- Salary up to $92,000 annually
- Eligible for discretionary bonus consideration
- Comprehensive benefits package, including medical, dental, vision, and life insurance
- Generous Paid Time Off (PTO) ranging from 17-27 days per year, based on tenure
- Opportunity for career advancement and professional development
- Work remotely with the flexibility to maintain a dedicated and secure workspace

What to Expect (Job Responsibilities):
- Analyze and audit inpatient claims, ensuring compliance with coding principles and clinical guidelines
- Utilize proprietary auditing systems to make informed audit determinations and generate necessary documentation
- Meet or exceed productivity and accuracy standards set by management
- Identify new claim types and suggest process improvements for enhanced recovery opportunities
- Complete special projects and additional duties as assigned, while maintaining a high level of independence in work

What is Required (Qualifications):
- Associate or bachelor’s degree in nursing (active/unrestricted license) or 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 and compliance standards, including DRG, ICD-10, CPT, and HCPCS codes
- Proficiency in Microsoft Word, Access, Excel, and TEAMS, with excellent written and verbal communication skills

How to Stand Out (Preferred Qualifications):
- Experience in a healthcare auditing role with a focus on inpatient claims
- Familiarity with payer reimbursement policies and medical necessity criteria
- Working knowledge of industry-based standards and guidelines
- Strong analytical skills to assess the accuracy and thoroughness of audit findings

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