Profee Audit Specialist

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.

Datavant is a data platform 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 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.    

What You Will Do:

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!

What You Need To Succeed: 

• Conduct comprehensive professional fee coding audits on medical records.
• Validate the accuracy of professional fee codes, including ICD-10-CM, CPT, HCPCS codes, and modifiers.
• Review patient E/M records, multiple specialties (including surgeries and hospital/office procedures), and evaluation and management services using the 2023 E/M Coding Guidelines.
• Educate coders through the auditing process.
• Prepare preliminary results for client review.
• Review ICD-10-CM, CPT, and HCPCS recommendation disagreements with appropriate and professional communication.
• Keep abreast of regulatory changes.
• Organize and prioritize multiple cases concurrently to ensure departmental workflow and case resolution.
• Exhibit a high level of complexity in work functions and decision-making, while showcasing strong organizational, teamwork, and leadership skills.

What you will bring to the table: 

• 5+ years of coding and auditing experience
• Associate or Bachelor's degree from an AHIMA-certified HIM or Nursing Program, or completion of a certificate program from AAPC with a preference for CCS
• CCS and RHIA or RHIT credentials preferred
• Recent experience in academic/level 1 trauma centers
• Experience coding and auditing inpatient and outpatient records for various facilities
• 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

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
• Benefits for PRN employees: 401k savings plan w/match 
• Free CEUs every year
• Stipend provided to assist with education and professional dues (AHIMA/AAPC)
• 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!)

 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. Our compensation philosophy is to be externally competitive, internally fair, and not win or lose on compensation. Salary ranges for this position are developed with the support of benchmarks (competitive San Francisco rates for US-based roles) and industry best practices.   We’re building a high-growth, high-autonomy culture. We rely less on job titles and more on cultivating an environment where anyone can contribute, the best ideas win, and personal growth is driven by expanding impact. This means we default to simple job titles (e.g., Software Engineer) rather than complex ones (e.g., Senior Software Engineer). The range posted is for a given job title, which can include multiple levels. Individual rates for the same job title may differ based on level, responsibilities, skills, and experience for a specific job.

The estimated pay range for this role is $35.00- $40.00 per hour. At the end of this application, you will find a set of voluntary demographic questions. If you choose to respond, your responses will be anonymous and used to help us identify areas of improvement in our recruitment process. (We can only see aggregate responses, not individual responses. In fact, we aren’t even able to see if you’ve responded or not.) Responding is your choice and it will not be used in any way in our hiring process. This job is not eligible for employment sponsorship.

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. Learn more here.

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 peopleteam@datavant.com. We will review your request for reasonable accommodation on a case-by-case basis.

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