Auditor/Educator In/Outpatient

Omega Healthcare Management Services Pvt. Ltd.; Boca Raton, Northern (FL, KY); Hybrid; USD 70,000 - 100,000; Full time

Benefits offered by this job

Health, Dental, Vision

401(k) with employer match

Professional development

Paid time off

Holiday pay

Bonus programs

Job summary

Omega Healthcare Management Services Pvt. Ltd. seeks a CDI Auditor in Boca Raton, FL to conduct initial quality audits during onboarding and educate staff based on findings.

The role reviews medical records for accuracy of coding, identifies documentation gaps, and ensures compliance with coding guidelines and payer rules. You will analyze CDI performance data and provide training to clinicians and staff. Candidates should have CDI credentials (CCS/CIC/CPC/COC), strong clinical and coding

Qualifications

• Strong clinical knowledge of disease processes and medical terminology.
• Familiarity with ICD-10-CM/PCS, CPT, and other coding systems.
• Experience in clinical documentation integrity including chart review and query writing.

Responsibilities

• Perform initial quality audits during onboarding for new projects or clients and educate staff on findings.
• Audit medical records to ensure documentation reflects diagnoses, severity, and mortality risk.
• Ensure documentation complies with regulatory requirements, coding guidelines, and payer rules.

Skills

Clinical Knowledge

Coding Knowledge

CDI Experience

Analytical Skills

Communication Skills

ICD-10-CM/PCS

CPT Knowledge

Education

CDI Certifications (CCS/CIC/CPC/COC)

Job description

Essential Job Functions:
Initial Audit and Education:

• For assigned coding staff, conduct initial quality audits as they go through onboarding process for new project / client assignment, and provide education to staff based on initial quality audit findings. Reviewmedicalrecordsforaccuracyofcodinganddataquality.Elementsincludedinreviewsmayinclude:
• Auditing:
  • Reviewing medical records, including clinical notes, lab results, and other diagnostic information, to ensure documentation accurately reflects diagnoses, severity of illness, and risk of mortality.
• Compliance:
  • Ensuring documentation complies with regulatory requirements, coding guidelines, and payer rules.
• Identifying Gaps:
  • Identifying missed documentation opportunities, inconsistencies, and areas where documentation can be more specific or clarified.
• Query Review:
  • Evaluating the appropriateness of queries issued to physicians, ensuring they are supported by clinical evidence and aligned with coding guidelines.
• Data Analysis:
  • Analyzing data related to CDI performance, identifying trends, and reporting findings to leadership.
• Education and Training:
  • Providing education and training to CDI staff, physicians, and other healthcare professionals on documentation best practices, coding guidelines, and regulatory requirements.
• Skills and Qualifications:
• Clinical Knowledge:
  • Strong understanding of disease processes, clinical conditions, and medical terminology.
• Coding Knowledge:
  • Familiarity with ICD-10-CM/PCS, CPT, and other relevant coding systems.
• CDI Experience:
  • Experience in clinical documentation integrity, including chart review and query writing.
• Analytical Skills:
  • Ability to analyze data, identify trends, and make recommendations for improvement.
• Communication Skills:
  • Excellent written and verbal communication skills to effectively communicate with various healthcare professionals.
• AlldiagnosisandprocedureassignedICD-10-CMandICD-10PCScodes
• Appropriateness of queries created

OutpatientCases(ER,SDS,Ancillary)

• AlldiagnosisandprocedureassignedICD-10-CMandICD-10PCScodes
• AllCPTassignedcodes
• APCassignment

Qualifications

CCS, or CIC, CPC and COC

About Us

Founded in 2003, Omega Healthcare Management Services® (Omega Healthcare) empowers healthcare to thrive via intelligent solutions that optimize revenue cycle operations, administrative workflows, care coordination, and clinical research on a global scale. The company works with providers, payers, life science companies, medical device manufacturers, health technology firms, researchers, and industry partners to amplify teams with robust technology, specialty expertise, and operational support. Omega Healthcare serves more than 350 healthcare organizations with 35,000 skilled workers in the United States, India, Colombia, and the Philippines. For more information, visitwww.omegahms.com

We offer a comprehensive benefits package that may include:

• health, dental, and vision coverage
• voluntary insurance options
• a 401(k) plan with employer match
• professional development opportunities
• paid time off
• holiday pay
• bonus programs, commissions, or other variable incentive plans

Benefits and incentive eligibility may vary based on position, location, and tenure.

AAP/EEO Statement

Omega Healthcare is an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to their race, color, religion, national origin, gender, age, sexual orientation, gender identity or expression, marital status, mental or physical disability, protected veteran status, and genetic information, or any other basis protected by applicable law. Omega Healthcarealso prohibits harassment of applicants or employees based on any of these protected categories.

Omega Healthcare makes reasonable accommodations when needed for applicants and candidates with disabilities or religious observances. If reasonable accommodation is needed to participate in the job application, interview, or any other part of the hiring process, please contact Human Resources [e-mail] .