Inpatient/Outpatient Facility Coding Auditor
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Job Description
Inpatient/outpatient coding auditor advising U.S. healthcare clients for PYA, a professional services firm. Validating coding, reimbursement, documentation, and compliance across hospital settings.
Responsibilities:
- Apply inpatient and outpatient facility/hospital coding and reimbursement methodologies to provide advisory services to PYA clients
- Assign ICD-10-CM and PCS/CPT/HCPCS codes
- Perform MS-DRG and other DRG validation
- Perform APC validation and charge capture review
- Support clinical documentation improvement
- Address regulatory compliance for third-party payors
- Collaborate with the PYA executive team and other service lines to offer complete business solutions to clients
- Manage preparation of excellent client deliverables
- Manage projects while balancing firm risk, compliance, and appropriate professional standards
- Support management of PYA staff
- Manage client relationships with professionalism, executive presence, and candor
Requirements:
- Professional credential required, such as CCS, RHIA, RHIT, CIC, or another AHIMA- or AAPC-approved coding credential
- Minimum of 7 years of inpatient coding auditing and reimbursement experience in a hospital setting or with a professional services firm preferred
- Previous experience working with a professional services firm preferred
- Demonstrated expertise in medical terminology, including anatomy and physiology
- Demonstrated expertise in medical coding auditing, with knowledge of billing, coding, and documentation practices in inpatient and outpatient hospital settings
- Adept knowledge of Microsoft Office Suite
- Excellent written and oral communication skills
- Ability to handle multiple projects
- Leadership skills supporting management of PYA staff
- Ability to manage client relationships with professionalism, executive presence, and candor
- Alternative bonus: demonstrated expertise in professional fee coding auditing and credentialed in the same, such as CPC or CCS-P
Benefits:
- Competitive compensation
- Comprehensive benefits
- Opportunities for career advancement
- Dynamic and collaborative team
- Professional growth opportunities
- Work with industry leaders committed to professional growth and client success
- Innovative solutions and unparalleled service
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