Datavant
Pro Fee Audit Specialist Full Time
Job Summary
The role involves performing professional fee coding audits of medical records using industry-standard coding systems such as ICD-10-CM, CPT, and HCPCS, with a focus on accuracy and regulatory compliance. The specialist provides detailed rationale for coding changes and educates coders through the auditing process, while staying current with regulatory updates. Candidates need at least five years of coding or auditing experience, CPC certification, and familiarity with electronic medical records. The position is remote, offers comprehensive benefits, and emphasizes professionalism, customer service, and continuous learning.
Required Skills
Benefits
Job Description
Datavant is a data platform company and the world’s leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format.
Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world’s leading life sciences companies, government agencies, and those who deliver and pay for care.
By joining Datavant today, you’re stepping onto a high-performing, values-driven team. Together, we’re rising to the challenge of tackling some of healthcare’s most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare.
What We’re Looking For:
As a Profee Auditing Specialist, you will be instrumental in addressing consulting and educational needs related to coding quality, compliance assessments, external payer reviews, coding education, interim coding management, and coding workflow operations reviews. In this role, you will offer meaningful information tailored to exceed customer expectations, actively identifying and presenting solutions for customer issues. This role is fully remote with a flexible schedule, allowing you to help shape the future of healthcare from your own workspace!
******Preferred: Skill set in Pro Fee ED, Outpatient Facility ED and Injections and Infusions*****
What You Will Do:
- Performs Professional Fee coding audits of medical records and abstracts using ICD-10-CM, CPT, HCPCS, and modifiers and appropriate coding references for accurate coding assignment.
- Provides rich and concise rationale explaining the reasoning behind any identified changes, including specific references, location of documentation, etc
- Keeps abreast of regulatory changes
- Organizes and prioritizes multiple cases concurrently to ensure departmental workflow and case resolution
- Provides coder education via the auditing process
- Function in a professional, efficient and positive manner
- Adhere to the American Health Information Management Association (AHIMA)’s code of ethics
- Must be customer-service focused and exhibit professionalism, flexibility, dependability, desire to learn, commitment to excellence and commitment to profession
- High complexity of work function and decision making
- Strong organizational, teamwork, and leadership skills
******Preferred: Skill set in Pro Fee ED, Outpatient Facility ED and Injections and Infusions*****
What You Need to Succeed:
- 5+ years of Professional Fee coding and/or auditing
- CPC (required)
- CPMA (preferred)
- Maintain 95% accuracy rate
- Experience with various software including Epic, Cerner, and other prevalent EMRs
What We Offer:
- Benefits for Full-Time employees: Medical, Dental, Vision, 401k Savings Plan w/match, 2 weeks of paid time off, and Paid Holidays, Floating Holidays
- Free CEUs every year
- Stipend provided to assist with education and professional dues (AHIMA/AAPC) If Applicable
- Equipment: monitor, laptop, mouse, headset, and keyboard
- Comprehensive training led by a credentialed professional coding manager
- Exceptional service-style management and mentorship (we’re in this together!)
Pay ranges for this job title may differ based on location, responsibilities, skills, experience, and other requirements of the role.
The estimated base pay range per hour for this role is: $35 - $45 an Hour
Pay ranges for this job title may differ based on location, responsibilities, skills, experience, and other requirements of the role.
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 Datavant 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.
This job is not eligible for employment sponsorship.
Datavant is committed to a work environment free from job discrimination. We are proud to be an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, or other legally protected status. To learn more about our commitment, please review our EEO Commitment Statement here. Know Your Rights, explore the resources available through the EEOC for more information regarding your legal rights and protections. In addition, Datavant does not and will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay.
At the end of this application, you will find a set of voluntary demographic questions. If you choose to respond, your answers will be anonymous and will help us identify areas for improvement in our recruitment process. (We can only see aggregate responses, not individual ones. In fact, we aren’t even able to see whether you’ve responded.) Responding is entirely optional and will not affect your application or hiring process in any way.
Datavant is committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities. If you need an accommodation while seeking employment, please contact us at [email protected]. We will review your request for reasonable accommodation on a case-by-case basis.
For more information about how we collect and use your data, please review our Privacy Policy.
Datavant
Join Datavant’s network of networks, including 300+ real-world data partners, more than 70,000 hospitals and clinics, and 70% of the top 100 largest health systems.
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