Internal Outpatient Audit Specialist

Overview

Datavant protects, connects, and delivers the world’s health data to power better decisions and advance human health. We are a data logistics company for healthcare whose products and solutions enable organizations to move and connect data securely. Datavant has a network of networks consisting of thousands of organizations, more than 70,000 hospitals and clinics, 70% of the 100 largest health systems, and an ecosystem of 500+ real-world data partners. 

By joining Datavant today, you’re stepping onto a highly collaborative, remote-first team that is passionate about creating transformative change in healthcare. We hire for three traits: we want people who are smart, nice, and get things done. We invest in our people and believe in hiring for high-potential and humble individuals who can rapidly grow their responsibilities as the company scales. Datavant is a distributed, remote-first team, and we empower Datavanters to shape their working environment in a way that suits their needs.  

As an Outpatient 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!

Responsibilities

What you will do:

The Outpatient Auditing Specialist will use various guidelines and precedents to perform coding quality review services on behalf of Datavant’s auditing partners.  The Outpatient Audit Specialist will make determinations on the appropriateness of inpatient coding elements, identify performance trends, and will make recommendations on performance improvement. The Outpatient Auditing Specialist will work cooperatively with  auditing peers, auditing leadership, and client partners to develop and sustain optimized auditing practices.

• Performs outpatient coding audits according to scope of work using appropriate assignment of codes and other coding-related elements, records findings
• Provides rich rationale explaining the reasoning behind any identified changes, including specific references, location of documentation, etc.
• Utilizes licensed auditing technology as instructed, assigns outcomes according to established hierarchy
• Utilizes internal workflow as instructed
• Attend coding workshops as necessary to further education
• Keeps abreast of regulatory changes.
• Organizes and prioritizes multiple cases concurrently to ensure optimal workflow and turnaround time
• Escalates any issues, auditing-related or coding related to Auditing Lead
• Shows versatility and flexibility and is able to pivot from one assignment to another as directed by Lead and/or Management.
• Utilizes internal decision support resources (e.g. Teams environment) to make fully-informed decisions
• Demonstrate initiative and judgment in performance of job responsibilities.
• 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.
•  High complexity of work function and decision making
•  Strong organizational, teamwork, and leadership skill

Qualifications

What you will bring to the table:

• 5+ years of facility outpatient coding experience
• 5+ years of facility (hospital) auditing experience
• CPC and RHIA or RHIT credentials preferred.
• Experience in academic/level 1 trauma centers
• Track record of acceptable productivity standards
• Maintain 95% APC accuracy rate and 80% accuracy rate for all other coding elements
• Experience with various software including Epic, Cerner, and other prevalent EMRs.

Pay ranges for this job title may differ based on location, responsibilities, skills, experience, and other requirements of the role. The estimated pay range for this role is $35.00 - $45.00 per hour.

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.

With very limited exceptions (medical conditions or sincerely held religious beliefs that prohibit you from getting the vaccine), one of the requirements for this job is that you be fully vaccinated against COVID-19.

*Except for states where legally prohibited to enforce mandates.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

This job is not eligible for employment sponsorship.

Equal Pay Act Minimum Range