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!

What you will do:

• Performs Professional Fee encounter reviews of inpatient, outpatient and clinic based medical records and abstracts using ICD-10-CM, CPT, HCPCS and modifiers and appropriate coding references for appropriate coding assignment.
• Reviews all HCPCS and CPT codes impacting RVU assignment
• Provides coder education via the auditing process
• Prepares preliminary results for review by the facility or CCS HIM director
• Reviews coding recommendation disagreements with appropriate manager
• Prepares the final reports for the coding audit. Participates in settlement of audit findings.
• Provides coder education via email and/or conference call using the audit spreadsheet findings and comments
• Attends coding workshops as necessary
• Keeps abreast of regulatory changes
• Organizes and prioritizes multiple cases concurrently to ensure departmental workflow and case resolution
• Shows versatility and exemplary work including a wide range of services coded
• Meets with client facility representatives to discuss issues and trends identified in audit
• Develops and implements education for physician, nursing, and other clinical staff to improve documentation
• Demonstrate initiative and judgment in performance of job responsibilities
• Communicates with co-workers, management, and hospital staff regarding clinical and reimbursement issues
• Function in a professional, efficient and positive manner
• Adhere to the American Academy of Professional Coders (AAPC)’s code of ethics
• Must be customer-service focused and exhibit professionalism, flexibility, dependability, desire to learn, commitment to excellence and commitment to profession
• Audits external coding staff as needed and provides reports to manager as directed
• High complexity of work function and decision making
• Strong organizational, teamwork, and leadership skills

What you bring to the table:

• Minimum of 3 years’ experience coding or auditing
• CPC and/or CPMA credentials required
• Recent experience in academic/level 1 trauma centers
• Experience coding or auditing the Professional Fee encounters for inpatient, outpatient and clinic- based records for various facilities
• Track record of acceptable productivity standards
• Maintain 95% accuracy rate for code assignment and 95% productivity rate
• Experience with various software including EMR, Encoder and Auditing software

Perks:

• 401k Savings Plan 
• Company-provided equipment including computer, monitor, mouse, etc

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 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. Please note that 1 or more assessments may be required as a condition to being hired for this role. There is no COVID vaccine requirement for this role.

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 - $40 per hour.

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.