Remote Outpatient Coding Validation Specialist

Machinifyinc; United States; On-site; USD 85,000 - 100,000; Full time

Benefits offered by this job

Work from anywhere in the US

Top Medical/Dental/Vision offerings

Tuition reimbursement

401(k) with company match

Health and wellness benefits

Job summary

Machinifyinc is looking for a Coding Validation Specialist to join their Complex Payment Solutions Team. This role involves comprehensive review of outpatient payment validation, ensuring accuracy in coding, billing, and documentation.

The successful candidate will have a strong understanding of ICD-10-CM/PCS, CPT, and HCPCS coding guidelines, as well as significant experience in outpatient reimbursement methodologies. The position offers the flexibility to work from anywhere in the US.

Qualifications

• At least 2 years of experience performing pre-pay and/or post-pay reimbursement audits.
• 5-7 years of experience in outpatient facility coding/auditing.
• Broad outpatient facility auditing experience, including specialty areas.

Responsibilities

• Conduct comprehensive reviews to validate the accuracy of billed charges against medical documentation.
• Ensure appropriate reimbursement by applying coding guidelines across a broad range of outpatient services.
• Develop and apply rationales for coding changes impacting reimbursement.

Skills

Attention to detail

Expert-level proficiency in ICD-10-CM/PCS

Knowledge of outpatient reimbursement methodologies

Excellent verbal and written communication skills

Strong analytical skills

Education

Associate's or Bachelor's degree in Health Information Management

Active certification including RHIT, RHIA, CCS, and/or CPC

Tools

Grouper/Pricer Software

ICD-10-CM encoders

Job description

Machinifyinc is looking for a Coding Validation Specialist to join their Complex Payment Solutions Team. This role involves comprehensive review of outpatient payment validation, ensuring accuracy in coding, billing, and documentation.

The successful candidate will have a strong understanding of ICD-10-CM/PCS, CPT, and HCPCS coding guidelines, as well as significant experience in outpatient reimbursement methodologies. The position offers the flexibility to work from anywhere in the US.