ProFee Audit Specialist- PRN

Datavant; Columbus (OH); On-site; USD 48,216 - 61,992; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

401k Savings Plan with match

Paid time off

Job summary

Datavant is seeking a Professional Fee Auditing Specialist to conduct medical coding audits for various healthcare organizations. This fully remote role allows for a flexible schedule, and the ideal candidate will possess at least 5 years of coding or auditing experience and relevant certifications such as CPC. Responsibilities include performing audits, providing coder education, and maintaining high accuracy in coding assignments. Datavant offers a comprehensive benefits package including medical, dental, and stipends for professional dues.

Qualifications

• 5+ years of Professional Fee coding and/or auditing experience required.
• CPC certification is necessary; CPMA preferred.
• Must maintain a 95% accuracy rate.

Responsibilities

• Perform Professional Fee coding audits of medical records using appropriate coding references.
• Provide clear rationale for coding changes and keep abreast of regulatory changes.
• Organize and prioritize multiple cases to ensure efficient workflow.

Skills

Professional Fee coding

Auditing

Customer service focus

Organizational skills

Leadership skills

Education

CPC certification (required)

CPMA certification (preferred)

5+ years of experience

Tools

Epic

Cerner

Various EMRs

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, Datavant builds 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 Professional Fee 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!

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.
• Functions in a professional, efficient and positive manner.
• Adheres 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.
• Handles high complexity of work function and decision making.
• Demonstrates strong organizational, teamwork, and leadership skills.

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.

The estimated base pay range per hour for this role is: $35—$45 USD.

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. For more information, review our EEO Commitment Statement (https://www.datavant.com/eeo-commitment-statement). Know Your Rights (https://www.eeoc.gov/know-your-rights-workplace-discrimination-illegal).