Audit Specialist at Ciox Health

Location: Remote, US
| Full-time | Part-time
Ciox Health

Audit Specialist

Job LocationsUS-Remote

Requisition ID

2022-27110

# of Openings

10

Category (Portal Searching)

HIM / Coding

Overview

Who we are…

Ciox Health merged with Datavant in 2021, creating the nation’s largest health data ecosystems, powering secure data connectivity on behalf of thousands of providers, payers, health data analytics companies, patient-facing applications, government agencies, research institutions and life science companies. The combined company is focused on improving patient outcomes and reducing costs by removing impediments to the secure exchange of health data. Ciox, a Datavant company will offer the ability to access, exchange, and connect data among the thousands of organizations in its ecosystem for use cases ranging from better clinical care and value-based payments to health analytics and medical research.

What we offer…

At Ciox Health we offer all employees a place to grow and expand their current skills so that they can not only help build Ciox Health into the greatest health technology company but create a career that you can be proud of. We offer you complete training and long-term career goals. Our environment is what most of our employees are the proudest of and our Auditing/Coding Team is comprised of some of the brightest and most talented individuals. Give us just a few moments to explain why we need you and hope you will help us change how the health Industry manages its’ medical records.

What we need…

The Auditing Specialist will respond to consulting and education needs related to coding quality, compliance assessments, external payer reviews, coding education, interim coding management and coding workflow operations reviews. Offer meaningful information to meet customer expectations including identifying and proposing solutions for customer issues. Develop and maintain account relationships through responsiveness and calm, reflective work practices. Work cooperatively with the Data Quality & Coding Compliance leadership and scheduling for optimal services outcome.

Details:

  • Full time and PRN positions available, flexible schedules,
  • Location: Remote/Work from home, equipment provided.
  • Required: A minimum of 3 years of auditing experience.
  • Specific Experience with APRDRG andor EAPG required
  • Preferred: CCS, RHIT, or RHIA credentials.
  • Preferred: Recent academic medical center or level I trauma center auditing experience.

We Offer:

  • Full Benefits: 401k Savings Plan
  • 20-24 free CEUs per year, provided by Ciox
  • AAPC/AHIMA dues compensation
  • Company equipment will be provided to you (including computer, monitor, etc.)
  • Comprehensive training lead by a hiring manager
  • No Covid Vaccination requirement

Responsibilities

  • Performs inpatient and outpatient coding audits medical records and abstracts using ICD-10-CM CPT and appropriate coding references for appropriate DRG and APC assignment.
  • Reviews non-CC/MCC records to determine if record was properly coded or if additional
  • documentation is needed. Reviews all HCPCS and CPT codes impacting APC assignment
  • Provides coder education via the auditing process
  • Prepares preliminary results for review by the facility or CCS HIM director
  • Reviews APC/DRG change disagreements with appropriate manager
  • Prepares the final reports for the coding audit. Participates in settlement of audit findings.
  • Provides coder education via email and/or conference call using the audit spreadsheet findings and comments
  • Attends coding workshops as necessary
  • Keeps abreast of regulatory changes
  • Organizes and prioritizes multiple cases concurrently to ensure departmental workflow and case resolution
  • Shows versatility and exemplary work including a wide range of services coded
  • Meets with client facility representatives to discuss issues and trends identified in audit
  • Develops and implements education for physician, nursing, and other clinical staff to improve documentation
  • Demonstrate initiative and judgment in performance of job responsibilities
  • Communicates with co-workers, management, and hospital staff regarding clinical and reimbursement issues
  • Function in a professional, efficient and positive manner
  • Adhere to the American Health Information Management Association’s code of ethics
  • Must be customer-service focused and exhibit professionalism, flexibility, dependability, desire to learn, commitment to excellence and commitment to profession
  • Audits external coding staff as needed and provides reports to manager as directed
  • High complexity of work function and decision making
  • Strong organizational, teamwork, and leadership skills

Qualifications

  • Minimum of 3 years experience coding or auditing
  • CCS and RHIA or RHIT credentials preferred
  • Recent experience in academic/level 1 trauma centers
  • Experience coding or auditing inpatient and outpatient records for various facilities
  • APRDRG and/or EAPG experience required
  • Track record of acceptable productivity standards
  • Maintain 95% accuracy rate for APC assignment and 95% productivity rate
  • Experience with various software including EMR, Encoder and Auditing software

To ensure the safety of patients and staff, many of our clients require post-offer health screenings and proof and/or completion of various vaccinations such as the flu shot, Tdap, COVID-19, etc. Any requests to be exempted from these requirements will be reviewed by Ciox Human Resources and determined on a case-by-case basis. Depending on the state in which you will be working, exemptions may be available on the basis of disability, medical contraindications to the vaccine or any of its components, pregnancy or pregnancy-related medical conditions, and/or religion.

For remote work, this position requires that you provide a high-speed internet connection, subject to applicable expense reimbursement requirements (if any), and a work environment free from distractions.

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