Acuvance Coker - IP and OP Auditor

ROI Healthcare Solutions; United States; On-site; USD 70,000 - 90,000; Full time

Benefits offered by this job

401(k)

Health insurance

Life insurance

Paid time off

Vision insurance

Job summary

ROI Healthcare Solutions is seeking experienced Auditors for Remote Full-Time positions focusing on inpatient and outpatient chart audits. The role requires deep expertise in ICD coding, DRG assignments, and compliance to help clients prevent noncompliance.

Responsibilities include conducting comprehensive quality assurance on hospital claims, reviewing records for coding accuracy, and presenting findings to clinicians. Strong communication and proficiency with MS Office are essential.

Qualifications

• 5+ years in inpatient and outpatient auditing in an acute care facility.
• Active coding credentials recommended: CCS, CCS-P, CPC, CDIP, RHIT or RHIA.
• Proficiency in medical terminology and documentation research is required.

Responsibilities

• Conduct in-depth quality assurance audits of hospital claims to support ICD-10-CM/PCS codes and DRG assignments.
• Audit patient records for coding accuracy and compliance with regulations.
• Identify over/under coding and documentation gaps; prepare detailed audit reports.

Skills

Inpatient/outpatient auditing

Medical terminology

Coding assessments

Communications

Education

AA degree or equivalent

CCS/CCS-P/CPC/CDIP/RHIT/RHIA certifications

Tools

Microsoft Office (Excel, Word)

Job description

Remote Full Time Inpatient/Outpatient Auditor positions are currently available.Benefits offered for Full Time employees.Candidates MUST have a minimum of five years’ experience with an acute care hospital auditing inpatient and outpatient charts. Auditor will conduct coding assessments and billing audit validations to assist clients in preventing noncompliance issues.

Job Responsibilities

• Perform in-depth quality assurance audits of hospital claims to support ICD-10-CM and ICD-10 PCS codes and MS-DRG and APR-DRG assignments and/or CPT-4 and APC assignments, based on clinical documentation
• Audit patient records, reviewing diagnosis and procedures for coding compliance with local, state, federal coding regulations and guidelines
• Identify occurrences of “over” or “under” coding of patient records
• Identify potential documentation issues
• Prepare detailed reports on audit findings
• Present via webinar software, audit findings, education, and trends to physicians, coders, and/or other facility professionals

Requirements

• 5+ Years Inpatient and Outpatient Auditing experience with an Acute Care Facility
• Ideally, at least two active coding credentials: CCS, CCS-P, CPC, CDIP, RHIT and/or RHIA
• IVR coding is a plus
• Extensive knowledge of medical terminology and ability to research coding related questions
• Excellent oral and written communications skills
• Successfully pass pre-hire coding assessments
• AA degree, or equivalent preferred
• Knowledge of Microsoft Office software: Excel and Word

Summary

This Job Is Ideal for Someone Who Is:

• Dependable -- more reliable than spontaneous
• Adaptable/flexible -- enjoys doing work that requires frequent shifts in direction
• Detail-oriented -- would rather focus on the details of work than the bigger picture
• Autonomous/Independent -- enjoys working with little direction

Job Types: Full-time

• 401(k)
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Experience

• Acute care: 5 years (Required)
• Working as an IP and OPAuditor: 5 years (Required)

License/Certification

• CCS, CCS-P, COC, CDIP, RHIT or RHIA Certificate (Required)