Remote RAC Coding Auditor - Full-time / Part-time

As a part of the Tenet and Catholic Health Initiatives

family, Conifer Health Solutions is a leading healthcare business process

management services provider working to improve operational performance for

more than 600 clients so they can support financial improvement, enhance the

patient experience, and drive value-based performance. Through our revenue cycle management , patient communication s,

and value-based

care solutions, we empower healthcare decision makers---hospitals,

health systems, physicians, self-insured employers, and payers---to better

connect every point of care and wellness management. Are you ready to be

part of our solutions? Welcome to the company that gives you the

resources and incentives to redefine healthcare services, with a competitive

benefits package and leadership to take your career to the next step!

Conifer Health Solutions is currently hiring a Remote RAC auditor.

The Spec, CRC Coding Audit is responsible for retrospective auditing of

denied claims related to DRG reimbursement.

Under general virtual supervision, the Revenue Cycle Coder:

1) Regularly exercises

discretion and independent judgement when completing medical record quality

audits of clinical documentation including application of appropriate rules and

regulations related to ICD-9 CM diagnosis, principal DX coding, MSDRG

assignment, CPT, HCPCS or any other coding classification system to ensure

proper reimbursement.

2) Completing medical record audit and

documenting clinical rationale supporting: 1) modification to tertiary DRG; 2) written clinical appeal based on supporting

medical record documentation utilizing industry accepted coding guidelines/clinics;

and/or 3) not appealable determination.

KNOWLEDGE,

SKILLS, ABILITIES

To perform this job successfully, an

individual must be able to perform each essential duty satisfactorily. The

requirements listed below are representative of the knowledge, skill and/or

ability required. Reasonable accommodations may be

made to enable individuals with disabilities to perform the essential functions.

Demonstrates quality proficiency by

maintaining 97.5% accuracy.

Possesses excellent written, verbal and communication

skills

Possesses professional letter writing

skills

Critical thinker, able to make decisions

regarding coding standards independently

Ability to interact intelligently and

professionally with other clinical and non-clinical clients

Ability to multi-task and manage competing

priorities effectively

Demonstrates computer literacy including

typing skills and solid knowledge base of Microsoft Office suite including

Word, Excel, PowerPoint and Outlook, coding and abstracting software/hardware

Ability to work independently in a remote

environment

Ability to conduct research regarding

State/Federal guidelines and applicable regulatory processes related to Government

Audit processes.

Maintains coding credentials and completes

required continuing education

EDUCATION

/ EXPERIENCE

Include minimum education, technical

training, and/or experience required to perform the job.

4 years of comprehensive healthcare coding and

abstracting of government and non-government payers for inpatient and

outpatient records preferred.

4 years comprehensive healthcare

coding/documentation auditing experience or equivalent preferred.

4

years experience with encoders and computerized abstracting systems preferred

Required: Bachelors or Associates degree HIM discipline

or equivalent.

CERTIFICATES, LICENSES, REGISTRATIONS

Required: AHIMA or AAPC