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 …