Senior Medical Auditor

USA Solventum Health Information Systems, Inc.; Maplewood (MN); À distance; USD 84 000 - 115 000; Plein temps

Avantages offerts par ce poste

Medical benefits

Dental benefits

Vision benefits

HSA / Health Savings Accounts

Retirement benefits

Résumé du poste

Solventum is seeking a Senior Medical Auditor to perform routine and complex coding audits across E/M, Surgery, and IR/VIR services. You will review vendor and client coding, produce audit reports, and deliver educational sessions to improve accuracy and compliance.

Requirements include relevant degree or substantial experience with ICD-10-CM/PCS/CPT, AHIMA/AAPC certification, and strong Microsoft Office skills. Remote work with up to 10% domestic travel is possible.

Qualifications

• Bachelor’s degree or higher plus four years of combined experience with professional fee/facility auditing and/or ICD coding and/or CPT/HCPCS.
• Or, high school diploma/GED with eight years of combined experience in auditing and/or coding.
• Three years combined experience with ICD-10-CM, PCS, and CPT/HCPCS.
• AAPC/AHIMA certification (CPC, CPMA, CCS, CCS-P, RHIT, RHIA, RRC, CIRCC) required.
• One year of ICD-10 trained and proficient.
• Strong CPT/PCS/ICD-10 knowledge and compliance with regulations.

Responsabilités

• Performing monthly, quarterly pro-fee and/or facility E/M, Surgery, IR/VIR coding audits for clients.
• Conducting retrospective audits on vendor coders and individual clients for Quality Assurance.
• Performing educational sessions to vendors and clients based on audit results.
• Ensuring vendor and client compliance with official coding guidelines.
• Creating audit reports and summaries for clients in accordance with policies and procedures.
• Creating and maintaining auditing schedules.
• Supporting and educating internal coding team.
• Maintaining HIPAA compliance and following state and federal release of information guidelines.

Connaissances

Auditing experience

CPT/HCPCS coding knowledge

ICD-10-CM/PCS coding knowledge

Customer service

Organization and prioritization

Microsoft Excel / Office

Formation

Bachelor's degree or higher

High School Diploma/GED

Outils

Excel

Teams

Word

Description du poste

At Solventum, we improve lives by helping healthcare professionals do their best work. Join a team using innovation and insight to make a real impact on the future of healthcare. All roles listed are with Solventum, and we’re committed to protecting your personal information—learn more in our Privacy Policy: https://www.solventum.com/en-us/home/legal/website-privacy-statement/applicant-privacy/

Job Description:

Senior Medical Auditor

At Solventum, we enable better, smarter, safer healthcare to improve lives. As a new company with a long legacy of creating breakthrough solutions for our customers’ toughest challenges, we pioneer game-changing innovations at the intersection of health, material and data science that change patients' lives for the better while enabling healthcare professionals to perform at their best. Because people, and their wellbeing, are at the heart of every scientific advancement we pursue. We partner closely with the brightest minds in healthcare to ensure that every solution we create melds the latest technology with compassion and empathy. Because at Solventum, we never stop solving for you.

The Impact You’ll Make in this Role

• Performing monthly, quarterly pro-fee and/or facility E/M, Surgery, IR/VIR coding audits for clients
• Conducting retrospective audits on vendor coders and individual clients for Quality Assurance
• Performing educational sessions to vendors and clients based on the audit results
• Ensuring vendor and client compliance with official coding guidelines
• Creating audit reports and summaries for clients in accordance with policies and procedures
• Creating and maintaining auditing schedules
• Supporting and educating internal coding team.
• Maintaining strict HIPAA compliance and following all state and federal guidelines for release of information

Your Skills and Expertise

• Bachelor’s Degree or higher from an accredited university AND Four (4) years of combined experience with professional fee/Facility auditing and/or ICD coding and/or CPT/HCPCS.
• OR High School Diploma/GED from an accredited institution AND Eight (8) years of combined experience with professional fee/Facility auditing and/or ICD coding and/or CPT/HCPCS in lieu of the bachelor’s degree education requirement.
• AND In addition to the above requirements, the following are also required: Three (3) years combined experience with professional fee/Facility auditing and/or coding in ICD-10-CM, PCS, and CPT/HCPCS.
• AAPC and/or AHIMA certification (eg, CPC, CPMA, CCS, CCS-P, RHIT, RHIA, RRC, CIRCC).
• One (1) year of ICD-10 trained and proficient.
• Excellent customer service and customer relations skills. Must exhibit professionalism, flexibility, dependability, desire to learn, commitment to excellence and commitment to profession. Must maintain current working knowledge of CPT, PCS and ICD-10 coding principles and government regulation and policies. Working knowledge of Microsoft applications (eg, Excel, Teams, Word). Strong attention to detail, capable of working under time restraints. Ability to plan, organize and prioritize job duties under general supervision.

Work location:

Remote Travel: May include up to 10% domestic Relocation Assistance: Not authorized Must be legally authorized to work in country of employment without sponsorship for employment visa status (e.g., H1B status).

Supporting Your Well-being

Solventum offers many programs to help you live your best life – both physically and financially. To ensure competitive pay and benefits, Solventum regularly benchmarks with other companies that are comparable in size and scope.

The expected compensation range for this position is $83,600 - $114,950, which includes base pay plus variable incentive pay, if eligible. This range represents a good faith estimate for this position. The specific compensation offered to a candidate may vary based on factors including, but not limited to, the candidate’s relevant knowledge, training, skills, work location, and/or experience. In addition, this position may be eligible for a range of benefits (e.g., Medical, Dental & Vision, Health Savings Accounts, Health Care & Dependent Care Flexible Spending Accounts, Disability Benefits, Life Insurance, Voluntary Benefits, Paid Absences and Retirement Benefits, etc.). Additional information is available at: https://www.solventum.com/en-us/home/our-company/careers/#Total-Rewards

Responsibilities of this position include that corporate policies, procedures and security standards are complied with while performing assigned duties.

Solventum is an equal opportunity employer. Solventum will not discriminate against any applicant for employment on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, or veteran status.

A new healthcare company with a rich history. With more than 70 years of delivering healthcare innovations, we continue to move the industry forward by helping to solve our customers’ biggest challenges. 20,000+ employees worldwide. Solventum relies on the courage and the boundless insights of professionals worldwide to achieve exceptional results for our customers and those who rely on them. Healthcare that leads with heart and humility starts with listening and never finishes, only evolves. As long as healthcare challenges remain unsolved, we will be here, united by empathy and a relentless belief that countless lives are improved through our work. Operations in 38 countries. Driven by our dedication to improved outcomes for all we serve, we break through by making unprecedented connections that impact lives. In more than 300 offices and facilities around the world, we work closely with customers and partners to create positive healthcare outcomes that transcend borders. To realize our shared vision, we harness diverse talents and perspectives from every background to not only address our customers' most urgent priorities but anticipate the needs of the future