Inpatient Coding Auditor- Remote

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<span class="jobdescription"><p><span style="font-size:12.0pt;font-family:arial, helvetica, sans-serif">It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development.</span></p> <p> </p><p><span style="font-family:arial, helvetica, sans-serif;color:black;font-size:12.0pt"><strong>Summary</strong></span></p> <p> </p> <p><span style="font-family:arial, helvetica, sans-serif;color:black;font-size:12.0pt">We are seeking a talented individual for an<strong> </strong>Inpatient Coding Auditor, Senior Associate who is responsible for performing coding reviews of inpatient medical records and/or other documentation to determine correct coding as defined by review methodologies specific to the contract for which review services are being provided.  This involves accessing proprietary systems to audit medical records, accurately document findings and providing policy/regulatory support for determination. The candidate must have an extensive background in either facility-based inpatient coding and/or outpatient coding edits and has a high level of understanding in reimbursement guidelines specifically an understanding of the MS-DRG, AP-DRG and APR-DRG, ASC and APC payment systems.</span></p> <p> </p> <p> </p> <p><span style="font-family:arial, helvetica, sans-serif;color:black;font-size:12.0pt"><strong>What you will do</strong></span></p> <p> </p> <ul> <li style="font-family:arial, helvetica, sans-serif;color:black;font-size:12.0pt"><span style="font-family:arial, helvetica, sans-serif;color:black;font-size:12.0pt">Performs audits of inpatient medical record documentation to determine the accuracy of principal and secondary diagnosis (including MCC & CC) and procedure codes. Validates the assignment and sequencing of ICD-10 codes, discharge status, Hospital Acquired Conditions, POA assignment and DRG assignment.  Adheres to official coding guidelines, coding clinics and regulatory guidelines and mandates. Draws on advanced ICD-10 coding expertise to substantiate conclusions. Utilizes proprietary auditing systems with a high level of proficiency to document audit determinations and rationale. </span></li> <li style="font-family:arial, helvetica, sans-serif;color:black;font-size:12.0pt"><span style="font-family:arial, helvetica, sans-serif;color:black;font-size:12.0pt">Consistently achieves productivity and quality performance standards established by management.</span></li> <li style="font-family:arial, helvetica, sans-serif;color:black;font-size:12.0pt"><span style="font-family:arial, helvetica, sans-serif;color:black;font-size:12.0pt">Actively cross-trains to perform reviews of multiple claim types to provide a flexible workforce to meet client needs</span></li> <li style="font-family:arial, helvetica, sans-serif;color:black;font-size:12.0pt"><span style="font-family:arial, helvetica, sans-serif;color:black;font-size:12.0pt">Assists management with training new Coding Auditors to include daily monitoring, mentoring, feedback and education.</span></li> <li style="font-family:arial, helvetica, sans-serif;color:black;font-size:12.0pt"><span style="font-family:arial, helvetica, sans-serif;color:black;font-size:12.0pt">Maintains current knowledge of coding guidelines and successfully completes required CEUs to maintain coding certification.</span></li> <li style="font-family:arial, helvetica, sans-serif;color:black;font-size:12.0pt"><span style="font-family:arial, helvetica, sans-serif;color:black;font-size:12.0pt">Responsible for attending training and scheduled meetings to enhance skills and working knowledge of clinical policies, procedures, rules, and regulations.</span></li> </ul> <p> </p> <p> </p> <p><span style="font-family:arial, helvetica, sans-serif;color:black;font-size:12.0pt"><strong>What we are looking for</strong></span></p> <p> </p> <ul> <li style="font-family:arial, helvetica, sans-serif;color:black;font-size:12.0pt"><span style="font-family:arial, helvetica, sans-serif;color:black;font-size:12.0pt">One or more active professional credentials through AHIMA or AAPC: CPC, CCS, COC, RHIA, RHIT; required</span></li> <li style="font-family:arial, helvetica, sans-serif;color:black;font-size:12.0pt"><span style="font-family:arial, helvetica, sans-serif;color:black;font-size:12.0pt">2+ years experience of inpatient medical record coding and/or auditing; required</span></li> <li style="font-family:arial, helvetica, sans-serif;color:black;font-size:12.0pt"><span style="font-family:arial, helvetica, sans-serif;color:black;font-size:12.0pt">Demonstrated proficiency in medical record auditing and ICD-10 CM, ICD-10-PCS, APC, ASC, HCPCS, and CPT coding methodology.</span></li> <li style="font-family:arial, helvetica, sans-serif;color:black;font-size:12.0pt"><span style="font-family:arial, helvetica, sans-serif;color:black;font-size:12.0pt">Demonstrates a thorough understanding of the APR-DRG, AP-DRG, and MS-DRG</span></li> <li style="font-family:arial, helvetica, sans-serif;color:black;font-size:12.0pt"><span style="font-family:arial, helvetica, sans-serif;color:black;font-size:12.0pt">Demonstrated experience in medical record coding and auditing.</span></li> <li style="font-family:arial, helvetica, sans-serif;color:black;font-size:12.0pt"><span style="font-family:arial, helvetica, sans-serif;color:black;font-size:12.0pt">Demonstrated proficiency in computer skills and typing, i.e., Microsoft Windows, Outlook, Excel, Word, PowerPoint, Internet browsers and in virtual meeting tools i.e., Microsoft Teams, Zoom, etc.</span></li> </ul> <p> </p> <p> </p> <p><span style="font-family:arial, helvetica, sans-serif;color:black;font-size:12.0pt"><strong>What you should expect in this role</strong></span></p> <p> </p> <ul> <li style="font-family:arial, helvetica, sans-serif;color:black;font-size:12.0pt"><span style="font-family:arial, helvetica, sans-serif;color:black;font-size:12.0pt">Remote (work from home) environment</span></li> <li style="font-family:arial, helvetica, sans-serif;color:black;font-size:12.0pt"><span style="font-family:arial, helvetica, sans-serif;color:black;font-size:12.0pt">Benefits on first day of employment</span></li> <li style="font-family:arial, helvetica, sans-serif;color:black;font-size:12.0pt"><span style="font-family:arial, helvetica, sans-serif;color:black;font-size:12.0pt">Clear path advancement with training and leadership</span></li> </ul> <p style="font-family:arial, helvetica, sans-serif;color:black;font-size:12.0pt"> </p> <p style="font-family:arial, helvetica, sans-serif;color:black;font-size:12.0pt"> </p> <p style="font-family:arial, helvetica, sans-serif;color:black;font-size:12.0pt"><span style="font-family:arial, helvetica, sans-serif;color:black;font-size:12.0pt">Applications for this posting will be accepted until May 8, 2026. </span></p><p> </p> <p><span style="font-size:12.0pt;font-family:arial, helvetica, sans-serif">The pay range for this position is $65,000.00 - $80,000.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a <span style="color:#cb1ac6"><a style="color:#cb1ac6" href="https://jobs.gainwelltechnologies.com/content/benefits/?locale=en_US">401(k) employer match, comprehensive health benefits</a></span>, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.</span></p> <p><span style="font-size:12.0pt;font-family:arial, helvetica, sans-serif"> </span></p> <p><span style="font-size:12.0pt;font-family:arial, helvetica, sans-serif">We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our <span style="color:#cb1ac6"><a style="color:#cb1ac6" href="https://www.gainwelltechnologies.com/">company website</a></span> and visit our <span style="color:black"><span style="color:#cb1ac6"><a style="color:#cb1ac6" href="https://jobs.gainwelltechnologies.com/">Careers site</a></span></span> for all available job role openings.</span></p> <p><span style="font-size:11.0pt"><span style="font-family:Calibri"> </span></span></p> <p><span style="font-size:8.0pt"><span style="font-family:Arial, Helvetica, sans-serif"><em style="font-style:italic">Gainwell Technologies <span style="color:#32363a">is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. <span style="font-size:8.0pt;font-family:arial, helvetica, sans-serif">Gainwell Technologies defines “wages” and “wage rates” to include “all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.</span></span></em></span></span></p> </span>

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