Coding Auditor, Senior Associate job at Gainwell Technologies in US National

Gainwell Technologies LLC; United States; Remote; USD 51,000 - 72,000; Full time

Benefits offered by this job

Remote work within the United States

Benefits begin on the first day of EMP

401(k) employer match

Comprehensive health benefits

Educational assistance

Leadership development academies

Job summary

Gainwell Technologies is seeking a Senior Associate Inpatient Coding Auditor to review medical records and determine correct coding using MS-DRG/AP-DRG guidelines. This remote, US-based role offers flexibility and a clear path for professional growth.

You will access proprietary systems, document findings, and support policy determinations. The position is salaried, with benefits starting on day one, and requires AHIMA/AAPC credentials with 3+ years of inpatient/outpatient coding experience.

Qualifications

• Active professional credentials through AHIMA or AAPC.
• Three or more years of inpatient or outpatient claims coding experience.
• Proficiency in ICD-10-CM, ICD-10-PCS, APC, ASC, HCPCS, and CPT coding methodology.
• Thorough understanding of APR-DRG, AP-DRG, and MS-DRG.
• Demonstrated experience in medical record coding and auditing.

Responsibilities

• Perform audits of medical record documentation to determine the accuracy of principal and secondary diagnoses, including MCC and CC, and procedure codes.
• Adhere to official coding guidelines, coding clinics, and regulatory guidelines and mandates.
• Draw on advanced ICD-10 coding expertise to substantiate conclusions.
• Utilize HMS proprietary auditing systems with a high level of proficiency to document audit determinations and rationale.
• Consistently achieve productivity and quality performance standards established by management.
• Actively cross-train to perform reviews of multiple claim types to provide a flexible workforce that meets client needs.
• Assist management with training new Coding Auditors, including daily monitoring, mentoring, feedback, and education.
• Maintain current knowledge of coding guidelines and successfully complete required continuing education units (CEUs) to maintain coding certification.
• Attend training and scheduled meetings to enhance skills and working knowledge of clinical policies, procedures, rules, and regulations.

Skills

ICD-10-CM

ICD-10-PCS

CPT Coding

HCPCS

Education

CPC, CCS, COC, RHIA, RHIT credentials

Job description

Coding Auditor, Senior Associate

Location: Remote - United States
Work Arrangement: 100% Remote (Work from Home)
Employment Type: Full-Time, Salaried
Salary Range: $50,500-$72,200 annually

Job Description

It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you've honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you'll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development.

Summary

We are seeking a talented individual for an Inpatient Coding Auditor, Senior Associate who is responsible for performing coding reviews of medical records and/or other documentation to determine correct coding as defined by review methodologies specific to the contract for which review services are being provided. This involves accessing proprietary systems to audit medical records, accurately documenting findings, and providing policy and regulatory support for determinations. The candidate must have an extensive background in either facility-based inpatient coding and/or outpatient coding edits and a high level of understanding of reimbursement guidelines, specifically MS-DRG, AP-DRG, and APR-DRG, ASC, and APC payment systems.

Responsibilities

• Perform audits of medical record documentation to determine the accuracy of principal and secondary diagnoses, including MCC and CC, and procedure codes.
• Adhere to official coding guidelines, coding clinics, and regulatory guidelines and mandates.
• Draw on advanced ICD-10 coding expertise to substantiate conclusions.
• Utilize HMS proprietary auditing systems with a high level of proficiency to document audit determinations and rationale.
• Consistently achieve productivity and quality performance standards established by management.
• Actively cross-train to perform reviews of multiple claim types to provide a flexible workforce that meets client needs.
• Assist management with training new Coding Auditors, including daily monitoring, mentoring, feedback, and education.
• Maintain current knowledge of coding guidelines and successfully complete required continuing education units (CEUs) to maintain coding certification.
• Attend training and scheduled meetings to enhance skills and working knowledge of clinical policies, procedures, rules, and regulations.

Required Qualifications

• One or more years of active professional credentials through AHIMA or AAPC, including CPC, CCS, COC, RHIA, or RHIT.
• Three or more years of inpatient or outpatient claims coding experience.
• Demonstrated proficiency in medical record auditing and ICD-10-CM, ICD-10-PCS, APC, ASC, HCPCS, and CPT coding methodology.
• Thorough understanding of APR-DRG, AP-DRG, and MS-DRG.
• Demonstrated experience in medical record coding and auditing.

Work Environment and Benefits

• Remote work-from-home environment within the United States.
• Benefits begin on the first day of employment.
• Clear path to advancement through training and leadership opportunities.
• Flexible vacation policy for salaried, full-time employees.
• 401(k) employer match.
• Comprehensive health benefits.
• Educational assistance.
• Leadership and technical development academies.

Compensation

Annual Salary Range: $50,500-$72,200.
The base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience, among other factors.

About Gainwell Technologies

Gainwell Technologies is an industry leader focused on improving healthcare through collaboration, innovation, and inclusion. The company provides opportunities for employees to grow their careers through work flexibility, learning, and professional development.