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Posted 2 weeks agoDRG Validation Coding Auditor
Remote
Requirements
- Performs independent reviews, interprets medical records, and applies in-depth knowledge of coding principles to determine billing/coding/documentation issues and quality concerns.
- Demonstrates high level of expertise in researching
- Has an extensive understanding of reimbursement guidelines, specifically related to DRG (MS, APR, Tricare, etc.) payment systems. Conducts DRG (ex.
- Responsible for maintaining current certification(s), CEU’s, and up-to-date knowledge of coding guidelines.
- Completes required education through internal application, compliance training and other mandatory educational requirements.
- Leverages ICD-10 coding expertise, clinical guidelines, and proprietary tools to substantiate conclusions.
- Proficiency in multiple EMR’s, encoders, and the Microsoft Office suite.
- 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.
- Must be inquisitive and demonstrate openness to innovation including AI to explore better processes and ways to alleviate friction and improve patient and client experiences.
- Minimum Education: Bachelors Degree or Equivalent
- Experience Certification Required: Candidates must have and keep current at least one of the following professional certifications (CCS Preferred): CPC (Certified Professional Coder) CCS (Certified Coding Specialist) RHIA (Registered Health Information Administrator) RHIT (Registered Health Information Technician) #LI-HB1 #LI-REMOTE Join an award-winning company Five-time winner of “Best in KLAS” 2020-2022, 2024-2025 Black Book Research's Top Revenue Cycle Management Outsourcing Solution 2021-2024 22
- Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement.
Experience
- Experience We Love: 5+ years of coding experience. 3+ years of facility coding audit
Benefits
- The Opportunity: CAREER OPPORTUNITY OFFERING: Bonus Incentives Paid Certifications Tuition Reimbursement Comprehensive
- Benefits Career Advancement This position pays between $69,400 to $104,100 annually based on experience.
- Final compensation will be determined based on experience.
- 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.
- Recognition – We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company.
- 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.
Contact
- If you require accommodation in the application process, please contact TA@ensemblehp.com .
Additional details
- Thank you for considering a career at Ensemble! Ensemble 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! O.N.E Purpose: Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations.
- Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation.
- Striving for Excellence: Execute at a high level by demonstrating our “Best in KLAS” Ensemble Difference Principles and consistently delivering outstanding results.
- The Inpatient/DRG Validation Coding Auditor performs documentation and coding audits for all acute inpatient services for clients.
- Identifies coding errors, compliance, and educational opportunities, and optimizes reimbursement by ensuring that the diagnosis/procedure codes and supporting documentation accurately support the services rendered and comply with ethical coding standards/guidelines and regulatory requirements.