Senior Medical Auditor

healthcare; Maplewood (MN); Remoto; USD 84.000 - 115.000; Tempo pieno

Descrizione del lavoro

Solventum, a leader in healthcare solutions, seeks a Senior Medical Auditor to perform pro-fee and facility audits, ensure coding guideline compliance, and deliver insightful audit reports for clients remotely across the United States.

The role requires strong experience in ICD-10-CM/PCS and CPT/HCPCS, along with AHIMA/AAPC certifications, to educate vendors and support internal teams while upholding HIPAA standards.

Competenze

• Three 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 year of ICD-10 trained and proficient

Mansioni

• Perform monthly, quarterly pro-fee and/or facility E/M, Surgery, IR/VIR coding audits for clients.
• Conduct retrospective audits on vendor coders and individual clients for Quality Assurance.
• Perform educational sessions to vendors and clients based on audit results.
• Ensure vendor and client compliance with official coding guidelines.
• Create audit reports and summaries for clients in accordance with policies and procedures.
• Create and maintain auditing schedules.
• Support and educate internal coding team.
• Maintain strict HIPAA compliance and follow all state and federal guidelines for release of information

Conoscenze

HIPAA compliance

Formazione

Bachelor’s Degree or higher

High School Diploma/GED

Strumenti

Microsoft Excel

Microsoft Teams

Microsoft Word

Descrizione del lavoro

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

As a Senior Medical Auditor,you will have the opportunity to tap into your curiosity and collaborate with some of the most innovative and diverse people around the world. Here, you will make an impact by:

• 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

To set you up for success in this role from day one,Solventumrequires (at a minimum) the following qualifications:

• 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

Additional qualifications that could help you succeed even further in this role include:

• 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 to10%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

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

By applying to this position, you acknowledge that Solventum recently publicly announced its intention to divest its Health Information Systems Business. See Solventum Announces Intent to Separate its Health Information Systems Business :: Solventum Corporation Newsroom. No decision has been made regarding the ultimate structure or timing of any potential transaction, and there can be no assurance that a separation will occur. Any transaction would be subject to customary approvals, including approval by Solventum's Board of Directors, regulatory requirements and other customary conditions. This position supports the Health Information Systems Business. If a future transaction involving that business were to occur, the impact on this role would be determined as part of that process and remain subject to applicable legal requirements, approvals and business decisions.

Onboarding Requirement: To improve the onboarding experience, you will have an opportunity to meet with your manager and other new employees as part of the Solventum new employee orientation. As a result, new employees hired for this position will be required to travel to a designated company location for on-site onboarding during their initial days of employment. Travel arrangements and related expenses will be coordinated and paid for by the company in accordance with its travel policy. Applies to new hires with a start date of October 1st 2025 or later.

Applicable to US Applicants Only: 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-RewardsResponsibilities of this position include that corporate policies, procedures and security standards are complied with while performing assigned duties.

Solventum is committed to maintaining the highest standards of integrity and professionalism in our recruitment process. Applicants must remain alert to fraudulent job postings and recruitment schemes that falsely claim to represent Solventum and seek to exploit job seekers.

Please note that all email communications from Solventum regarding job opportunities with the company will be from an email with a domain of @solventum.com. Be wary of unsolicited emails or messages regarding Solventum job opportunities from emails with other email domains.

Please note, Solventum does not expect candidates in this position to perform work in the unincorporated areas of Los Angeles County.

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.

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