Medical Facility Outpatient Auditor - Remote
IKS Health is seeking to hire a Facility Outpatient Auditor.
About IKS: www.ikshealth.com
At IKS Health, we are committed to revolutionizing healthcare through innovative technology that enhances patient communication and clinical efficiency. Our culture is rooted in collaboration, compassion, and innovation, empowering teams to make a tangible impact on the lives of patients and clinicians.
Job Summary:
Conducts clinical coding audits as defined by client contracts for audit service and internal quality assessment according to operational guidelines. The Audit staff will also contribute to the ongoing development and refinement of proprietary audit tools. The Auditor II Position will participate in mentor/trainer activities to internal coders as required by the deliverables of the contract and will be required to provide educational feedback and instruction to staff for coding guidelines as part of the internal quality review or external audit service projects.
Essential Job Responsibilities:
Client-Related Duties –
Coordinate and oversee the coder onboarding process for assigned clients
Manage the performance of all quality for assigned clients.
Monitor and enforce IKS Health's compliance and quality program.
Ensure adherence to State and National Practice Standards for coding.
Serve as an official resource for coding-related questions from the coding staff.
Provide project status reports to operational leadership, as requested.
Auditing Team Duties –
Work directly with the coding management team to ensure the educational needs of coders are met. Provide coaching, as needed. · Assures internal coding audits are completed accurately and timely · Conducts coding audits adhering to nationally recognized coding guidelines and standards · Generates narrative audit summary reports as needed. · Perform auditing for a broad spectrum of cases · Provide input and advice regarding educational topics based on audit trends · Represent company via professional meeting attendance and communication · Interact with audit peers, manager, coding staff, and operations team · Abides by the Standards of Ethical Coding as set forth by AHIMA · Maintains appropriate QA/QI and/or productivity logs or record entries ·
Additional duties as assigned.
Maintain Coding Knowledge and Serve as Coding Expert –
Attend internal and external meetings, as needed and requested to provide input. and act as a coding information resource/expert. · Ensure IKS'ss compliance with all regulatory agencies. Ensure AQuity is HIPAA compliant at all times. · Maintain all CEUs required for the position and attend educational seminars as needed.
IKS Excellence -
Demonstrate a commitment to excellence in serving the client.
Demonstrate Core Values of Integrity, Quality, Team, Continuous Improvement, Expertise, and Innovation.
Job Qualifications:
Education/Certification
RHIA, COC, RHIT, CCS
Experience
Minimum 3 years recent experience in auditing outpatient facility claims.
Advanced knowledge of CPT,, HCPCS, ICD-10 coding and CMS billing policies for facility services, E/M auditing and/or healthcare compliance DRG Validation
Knowledge and Skills
Broad-based audit experience with inpatient and outpatient ICD-10-CM/PCS and CPT coding.
Requires strong interpersonal communication skills, both verbal and written
Requires a high level of coding accuracy and attention to detail
Experience with using multiple encoders and systems
Excellent oral and written communication skills – must be detailed and articulate
Strong knowledge of Microsoft Word, Excel, PowerPoint, and Outlook is required
Outpatient Auditor candidates must demonstrate advanced knowledge of APC-based reimbursement, medical necessity documentation requirements, guidelines for Observation services, and any relevant coding and documentation guidelines for specialty care areas. Working knowledge of how to research within the Medicare Claims and Processing Manuals is essential.
Working Conditions:
Remote working environment; travel as required, extended periods of computer-based work.
Physical Demands:
Prolonged computer screen usage, keyboarding. Long periods of sitting are commensurate with computer-based work and work-related phone calls. Normal Travel Requirements
Equal Opportunity Employer of Minorities, Females, Protected Veterans, and Individuals with Disabilities.
Compensation and Benefits:
The pay range for this position is $38hr- $40hr. Pay is based on several factors, including but not limited to current market conditions, location, education, work experience, certifications, etc. Aquity Solutions offers a competitive benefits package including healthcare, 401 (k), and paid time off (all benefits are subject to eligibility requirements for full-time employees). Aquity Solutions is an equal opportunity employer and does not discriminate based on race, national origin, gender, gender identity, sexual orientation, protected veteran status, disability, age, or other legally protected status.
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About IKS: www.ikshealth.com
At IKS Health, we are committed to revolutionizing healthcare through innovative technology that enhances patient communication and clinical efficiency. Our culture is rooted in collaboration, compassion, and innovation, empowering teams to make a tangible impact on the lives of patients and clinicians.
Job Summary:
Conducts clinical coding audits as defined by client contracts for audit service and internal quality assessment according to operational guidelines. The Audit staff will also contribute to the ongoing development and refinement of proprietary audit tools. The Auditor II Position will participate in mentor/trainer activities to internal coders as required by the deliverables of the contract and will be required to provide educational feedback and instruction to staff for coding guidelines as part of the internal quality review or external audit service projects.
Essential Job Responsibilities:
Client-Related Duties –
Coordinate and oversee the coder onboarding process for assigned clients
Manage the performance of all quality for assigned clients.
Monitor and enforce IKS Health's compliance and quality program.
Ensure adherence to State and National Practice Standards for coding.
Serve as an official resource for coding-related questions from the coding staff.
Provide project status reports to operational leadership, as requested.
Auditing Team Duties –
Work directly with the coding management team to ensure the educational needs of coders are met. Provide coaching, as needed. · Assures internal coding audits are completed accurately and timely · Conducts coding audits adhering to nationally recognized coding guidelines and standards · Generates narrative audit summary reports as needed. · Perform auditing for a broad spectrum of cases · Provide input and advice regarding educational topics based on audit trends · Represent company via professional meeting attendance and communication · Interact with audit peers, manager, coding staff, and operations team · Abides by the Standards of Ethical Coding as set forth by AHIMA · Maintains appropriate QA/QI and/or productivity logs or record entries ·
Additional duties as assigned.
Maintain Coding Knowledge and Serve as Coding Expert –
Attend internal and external meetings, as needed and requested to provide input. and act as a coding information resource/expert. · Ensure IKS'ss compliance with all regulatory agencies. Ensure AQuity is HIPAA compliant at all times. · Maintain all CEUs required for the position and attend educational seminars as needed.
IKS Excellence -
Demonstrate a commitment to excellence in serving the client.
Demonstrate Core Values of Integrity, Quality, Team, Continuous Improvement, Expertise, and Innovation.
Job Qualifications:
Education/Certification
RHIA, COC, RHIT, CCS
Experience
Minimum 3 years recent experience in auditing outpatient facility claims.
Advanced knowledge of CPT,, HCPCS, ICD-10 coding and CMS billing policies for facility services, E/M auditing and/or healthcare compliance DRG Validation
Knowledge and Skills
Broad-based audit experience with inpatient and outpatient ICD-10-CM/PCS and CPT coding.
Requires strong interpersonal communication skills, both verbal and written
Requires a high level of coding accuracy and attention to detail
Experience with using multiple encoders and systems
Excellent oral and written communication skills – must be detailed and articulate
Strong knowledge of Microsoft Word, Excel, PowerPoint, and Outlook is required
Outpatient Auditor candidates must demonstrate advanced knowledge of APC-based reimbursement, medical necessity documentation requirements, guidelines for Observation services, and any relevant coding and documentation guidelines for specialty care areas. Working knowledge of how to research within the Medicare Claims and Processing Manuals is essential.
Working Conditions:
Remote working environment; travel as required, extended periods of computer-based work.
Physical Demands:
Prolonged computer screen usage, keyboarding. Long periods of sitting are commensurate with computer-based work and work-related phone calls. Normal Travel Requirements
Equal Opportunity Employer of Minorities, Females, Protected Veterans, and Individuals with Disabilities.
Compensation and Benefits:
The pay range for this position is $38hr- $40hr. Pay is based on several factors, including but not limited to current market conditions, location, education, work experience, certifications, etc. Aquity Solutions offers a competitive benefits package including healthcare, 401 (k), and paid time off (all benefits are subject to eligibility requirements for full-time employees). Aquity Solutions is an equal opportunity employer and does not discriminate based on race, national origin, gender, gender identity, sexual orientation, protected veteran status, disability, age, or other legally protected status.
Apply tot his job
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