Revenue Integrity Auditor

Louisville, KY or Chicago, IL
Operations
Full-time

Founded in 1999, ZirMed is the nation’s only company delivering proven end-to-end cloud-based business and clinical performance management solutions to meet the challenges of managing population health and optimizing fee-for-service and fee-for-value reimbursements. ZirMed combines innovative software development with the industry’s most advanced transactional network and predictive analytics platform to improve the business and process of healthcare, give organizations a clearer view of their financial and operational performance, and streamline critical connections between providers, patients, and payers.

We're always improving, always testing, always changing, and there's never a dull moment. In the rapidly changing world of healthcare technology, we stay ahead of the curve.

What is the purpose of this position?

We are looking for a Revenue Integrity Auditor who has a comprehensive understanding of medical terminology, hospital inpatient and/or outpatient coding, charge capture, CDM, and medical records. The candidate must be organized, detail-oriented, accurate, and professional and would, ideally, possess CPC certification and other coding credentials/clinical expertise.  The ideal candidate for this position can approach problem-solving challenges independently, has strong attention to detail and enjoys working in a fast-paced, collaborative and team-based environment.     

Do you fit our team?

    • Achieve and maintain assigned Client financial performance goals
    • Validation of potential missing charges, coding variances, and overcharges using proprietary technology and medical records
    • Assist in prediction enhancements to increase verification rates 

    • Self-sufficient with strong analytical and research skills
    • Working knowledge of hospital charging practices, payer reimbursement methodology, medical necessity criteria, and applicable industry based standards
    • Remain current on CPT, ICD, HCPC and modifier coding requirements
    • Experience preferred with one or more of the following specialties: Interventional Radiology, Invasive Cardiology, General Surgery, Orthopedic Surgery, Vascular Surgery, and Surgical Oncology
    • Proficient using Microsoft Office products and the ability to work effectively with computerized programs and databases
    • Ability to communicate effectively
    • Demonstrate independent judgment, discretion, and decision making abilities
    • Self-motivated, hardworking individual with a high attention to detail
    • Excellent organization skills

    • Experience
    • 3+ years of hospital auditing/coding experience with CPT, ICD, HCPCS and modifier coding
    • Experience working within the hospital environment preferred

    • Education/Certification
    •  CPC, RHIT, RHIA, or other coding/clinical certifications, credentials, or expertise preferred
    •  
      Must be authorized to work in the United States on a full-time basis for any employer.