Ensemble Health Partners
DRG Validation Coding Auditor
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Job Description
- Req#: R027502
Bonus Incentives
Paid Certifications
Tuition Reimbursement
Comprehensive Benefits
Career Advancement
This position pays between $51,700 – $99,000 based on experience
Quality Review - Monitors and audits inpatient and /or outpatient accounts across the system, looking at facility coding for inpatient and /or outpatient accounts. Performs annual performance, randomized and quality assurance reviews to assess comprehension of training efforts. Performs DRG Validation reviews, ensuring proper facility coding guidelines have been followed as well as reviewing for clinical support of the coded diagnoses. Also assists other external and regulatory audits.
Educating - Assesses the educational needs of coding staff that are contracted/employed and outlined in the client SOW and develops programs or researches educational resources to meet those needs. Assists with Task Force, CDE and quality department related education. Creates presentations, develops learning material, handbook and other educational materials
Edits/Denials/Coding - Assists with edits, denials and appeals. Also assists with coding and working holds on an as needed basis
Training - Assists with training new and existing staff. Develops all training materials and coding aids for both formal training and use by coders in daily work. Identifies coders to be cross-trained and suggests areas for training improvement. Assists in the implementation and administration of effective systems, processes, and procedures
Resource - Serves as a technical resource for all involved personnel; ensures that information is accurate and current, meeting professional coding standards. Performs miscellaneous job-related duties as assigned
Reporting - Provides reports of audit findings to coding management, individual coders and leadership as needed/requested along with providers that are contracted/employed and outlined in the client SOW (Included Provider verbiage). Assists with the creation of various documents and reports as requested. Immediately provides reports related to compliance risks when requested
5+ years of coding experience.
3+ years of facility coding audit experience (such as DRG and APC Validation) .
Proficiency in multiple EMR’s, encoders, and the Microsoft Office suite.
Educated in HIPAA regulations; must maintain strict confidentiality of patient and client information.
Consistently achieves quality and productivity standards.
Ability to organize and complete work in a timely manner.
Ability to read, write and effectively communicate in English.
Ability to understand medical/surgical terminology.
Above average written and verbal communication skills.
High School Diploma or GED
CPC (Certified Professional Coder)
CCS (Certified Coding Specialist)
RHIA (Registered Health Information Administrator)
RHIT (Registered Health Information Technician)
Innovation
Work-Life Flexibility
Leadership
Purpose + Values
- Associate Benefits – We offer a comprehensive benefits package designed to support the physical, emotional, and financial health of you and your family, including healthcare, time off, retirement, and well-being programs.
- Our Culture – Ensemble is a place where associates can do their best work and be their best selves. We put people first, last and always. Our culture is rooted in collaboration, growth, and innovation.
- Growth – We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement.
- Recognition – We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company.
Thank you for considering a career at Ensemble Health Partners!
Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country.
Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference
The Opportunity:
CAREER OPPORTUNITY OFFERING:
Develops and implements strategic needs analyses and training plans for coding leadership; coordinates and evaluates curriculum development and conducts the preparation and delivery of training for Facility Medical Coders employed by Ensemble and providers that are contracted/employed and outlined in the client SOW. Provides guidance and leadership to coding and billing management in the implementation and administration of effective systems, processes, and procedures. Performs annual performance reviews and quality assurance reviews to assess comprehension of training efforts. Serves as a technical resource for all involved personnel; ensures that information is accurate and current, meeting facility coding standards.
Job Responsibilities:
Experience We Love:
Minimum Education:
Required Certifications:
Candidates must have and keep current at least one of the following professional certifications ( CCS Preferred):
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#LI-REMOTE
Join an award-winning company
Three-time winner of “Best in KLAS” 2020-2022
2022 Top Workplaces Healthcare Industry Award
2022 Top Workplaces USA Award
2022 Top Workplaces Culture Excellence Awards
Bottom line, we believe in empowering people and giving them the tools and resources needed to thrive. A few of those include:
Ensemble Health Partners is an equal employment opportunity employer. It is our policy not to discriminate against any applicant or employee based on race, color, sex, sexual orientation, gender, gender identity, religion, national origin, age, disability, military or veteran status, genetic information or any other basis protected by applicable federal, state, or local laws. Ensemble Health Partners also prohibits harassment of applicants or employees based on any of these protected categories.
Ensemble Health Partners provides reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law. If you require accommodation in the application process, please contact TA@ensemblehp.com.
This posting addresses state specific requirements to provide pay transparency. Compensation decisions consider many job-related factors, including but not limited to geographic location; knowledge; skills; relevant experience; education; licensure; internal equity; time in position. A candidate entry rate of pay does not typically fall at the minimum or maximum of the role’s range.
About the company
Ensemble Health Partners is the leading revenue cycle management company for hospitals. We build relationships & find the best solutions to your challenges.