Coding Auditor
Remote
Provider Services /
Full-Time /
Remote
TREND Health Partners, tech-enabled payment integrity company. Our mission is to facilitate collaboration between payers and providers for mutual benefit and waste reduction, ultimately improving access to healthcare. We achieve this by aligning the common goals of payers and providers and fostering collaboration through a shared technology platform and seamless workflows.
Joining TREND Health Partners means becoming a part of a dynamic growing organization that promotes a collaborative and innovative work environment.
Our comprehensive compensation package includes competitive salaries, highly valued health insurance, a 401(k) plan with employer match, paid parental leave, and more.
The Coding Auditor’s primary responsibility is to analyze data from claim denials, identify opportunities for prioritizing claim reviews, and focus on target DRG’s to ensure appropriate review and coding sequence.
Role and Responsibilities
- Reviewing data to determine appropriate DRG targets
- Review and append the appropriate diagnosis coding sequence based on documentation supported to
- ensure an accurate DRG assignment
- Effectively communicate to clients when documentation deficiencies are realized and how to prevent
- future occurrences of the same
- Escalate to manager any situation outside the employee’s control that could adversely impact the
- business relationship.
- Always represent TREND and our clients in a professional manner.
- Cooperate with team members to meet goals and complete tasks.
- Collaborating with IT in a machine learning environment
- Prioritize workload to meet deadlines and goals using guidelines set out by manager.
- Achieve individual productivity and quality standards.
Qualifications
- Active AHIMA certification as RHIA, RHIT, CCS required. CPMA will be considered if the candidate has DRG Validation experience
- Minimum of two years’ DRG validation experience, 5 years preferred
- Deep knowledge of coding, anatomy and physiology, medical terminology and ICD-10 coding guidelines with experience in DRG validation a must
- Itemized Bill validation experience a plus
- Five years of inpatient and outpatient coding and data review with an emphasis on auditing
- Tracking/trending data with successful and effective outcomes
- Trucode, 3M, Webstrat experience required
- Microsoft Office Products, specifically EXCEL experience
Mental and Physical Demands
- This position will be exposed mainly to an indoor/office environment and will be expected to work in or around computers and printers.
- The nature of the work is sedentary, and the employee will be sitting most of the time.
- Essential physical functions of the job include typing and the repetitive motion to utilize computer software and hardware continuously throughout the day.
- Essential mental functions of this position include concentrating on analytical tasks, reading information, and verbal/written communication to others continuously throughout the day.
Related Duties As Assigned
- This job description documents the general nature and level of work but is not intended to be a comprehensive list of activities, duties, or responsibilities required for this position. Consequently, employees may be asked to perform other duties as required.
- Employees may also be asked to complete certain compliance requirements set forth by our Business Partners in the performance of their jobs including but not limited to requests for background and drug screenings and disclosures of personal health information or personally identifiable information.
- Exemptions as provided under the ADA and TITLE VII of the Civil Rights Act will be observed and followed.
- Reasonable accommodations may be made to enable individuals with disabilities to perform the functions outlined above.
$70,000 - $85,000 a year
