Profee Audit Specialist - FT

Datavant; Madison (WI); Remote; USD 70,000 - 90,000; Full time

Benefits offered by this job

Medical

Dental

Vision

401k with match

Paid time off

Paid holidays

Floating holidays

Free CEUs

Education stipend

Equipment provided

Training and mentorship

Job summary

Datavant is seeking a Profee Auditing Specialist to perform professional fee coding audits, provide rationale for coding changes, and stay updated on regulatory changes. The role offers remote work with flexibility and requires strong organizational skills. Experience with Epic/Cerner and a CPC certification are essential.

The role emphasizes customer service, ethics, and commitment to excellence, with comprehensive benefits and opportunities for professional development.

Qualifications

• 5+ years of Professional Fee coding and/or auditing.
• CPC certification is required.
• CPMA is preferred.
• Experience with Epic, Cerner, and other EMRs.

Responsibilities

• Perform Professional Fee coding audits of medical records using ICD-10-CM, CPT, HCPCS, and modifiers.
• Provide clear rationale for changes with references and documentation locations.
• Stay current with regulatory changes in coding and compliance.
• Prioritize and manage multiple cases to support workflow.
• Educate coders through the auditing process.
• Maintain professional and positive conduct.

Skills

Professional Fee coding

CPC

CPMA

Epic

Cerner

Tools

Epic

Cerner

Job description

Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world’s health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies. From fulfilling a single patient’s request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health.

By joining Datavant today, you’re stepping onto a driven and highly collaborative team that is passionate about creating transformative change in healthcare.

What We’re Looking For:

As a Profee 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!

Preferred: A candidate that has worked with multi-specialties. Prefer a candidate with availability within normal business hours, prefer 20 hours/week.

What You Will Do:

• Performs Professional Fee coding audits of medical records and abstracts using ICD-10-CM, CPT, HCPCS, and modifiers and appropriate coding references for accurate coding assignment.
• Provides rich and concise rationale explaining the reasoning behind any identified changes, including specific references, location of documentation, etc
• Keeps abreast of regulatory changes
• Organizes and prioritizes multiple cases concurrently to ensure departmental workflow and case resolution
• Provides coder education via the auditing process
• Function in a professional, efficient and positive manner
• Adhere to the American Health Information Management Association (AHIMA)’s code of ethics
• Must be customer-service focused and exhibit professionalism, flexibility, dependability, desire to learn, commitment to excellence and commitment to profession
• High complexity of work function and decision making
• Strong organizational, teamwork, and leadership skills

Preferred: A candidate that has worked with multi-specialties. Prefer a candidate with availability within normal business hours, prefer 20 hours/week.

What You Need to Succeed:

• 5+ years of Professional Fee coding and/or auditing
• CPC (required)
• CPMA (preferred)
• Maintain 95% accuracy rate
• Experience with various software including Epic, Cerner, and other prevalent EMRs

What We Offer:

• Benefits for Full-Time employees: Medical, Dental, Vision, 401k Savings Plan w/match, 2 weeks of paid time off, and Paid Holidays, Floating Holidays
• Free CEUs every year
• Stipend provided to assist with education and professional dues (AHIMA/AAPC) If Applicable
• Equipment: monitor, laptop, mouse, headset, and keyboard
• Comprehensive training led by a credentialed professional coding manager
• Exceptional service-style management and mentorship (we’re in this together!)

Pay ranges for this job title may differ based on location, responsibilities, skills, experience, and other requirements of the role.

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 job is not eligible for employment sponsorship.

Datavant is committed to a work environment free from job discrimination. We are proud to be an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, or other legally protected status. To learn more about our commitment, please review our EEO Commitment Statement here (https://www.datavant.com/eeo-commitment-statement) . Know Your Rights (https://www.eeoc.gov/know-your-rights-workplace-discrimination-illegal) , explore the resources available through the EEOC for more information regarding your legal rights and protections. In addition, Datavant does not and will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay.

At the end of this application, you will find a set of voluntary demographic questions. If you choose to respond, your answers will be anonymous and will help us identify areas for improvement in our recruitment process. (We can only see aggregate responses, not individual ones. In fact, we aren’t even able to see whether you’ve responded.) Responding is entirely optional and will not affect your application or hiring process in any way.

Datavant is committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities. If you need an accommodation while seeking employment, please request it here, (https://peopleteam.datavant.com/portal/en/newticket?departmentId=248697000248790029&layoutId=248697000248795462) by selecting the ‘Interview Accommodation Request’ category. You will need your requisition ID when submitting your request, you can find instructions for locating it here (https://app.tango.us/app/workflow/Greenhouse--Locating-Requisition-ID-2c7d618c8a8a423da4330ff12330695e) . Requests for reasonable accommodations will be reviewed on a case-by-case basis.

For more information about how we collect and use your data, please review our Privacy Policy (https://www.datavant.com/privacy-policy) .