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Urgent! DRG Coding Auditor - CDI Remote - $10K Sign On Bonus Job Opening In USA, USA – Now Hiring Tenet Healthcare
JOB SUMMARY
The CRC Auditor, conducts coding and documentation quality reviews and generates responses for cases that have been denied by commercial and government payors to ensure hospital inpatient, outpatient, and pro-fee claims, were coded and billed in accordance with nationally recognized coding guidelines, standards, regulations and regulatory requirements, as well as payor and billing guidelines.
The responses generated by the Auditor may include system documentation of findings and / or a formal appeal letter.
The Auditor will escalate trends to CRC leadership, Conifer Quality & Performance leadership and Conifer Compliance as warranted.
The Auditor will perform analysis on clinical documentation, evidenced based criteria application outcome, physician documentation, physician advisor input and complete review of the medical record related to clinical denials.
Assures appropriate action is taken within appeal time frames.
Communicates identified denial trends and patterns to the CRC leadership.
Provides expert application of evidence based medical necessity review criteria tool.
Works collaboratively to review, evaluate and improve the denial appeal process.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Include the following.
Others may be assigned.
KNOWLEDGE, SKILLS, ABILITIES
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.
The requirements listed below are representative of the knowledge, skill and/or ability required.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment.
This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings.
EDUCATION / EXPERIENCE
Includes minimum education, technical training, and/or experience required to perform the job.
Education
Experience
CERTIFICATES, LICENSES, REGISTRATIONS
PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
WORK ENVIRONMENT
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
OTHER
As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide.
We help our clients strengthen their financial and clinical performance, serve their communities and succeed at the business of healthcare.
Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost and access to healthcare.
Are you ready to be part of our solutions?
Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step!
Compensation and Benefit Information
Compensation
Benefits
Conifer offers the following benefits, subject to employment status:
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Unlock Your DRG Coding Potential: Insight & Career Growth Guide
Real-time DRG Coding Jobs Trends in United States, United States (Graphical Representation)
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Great news! Tenet Healthcare is currently hiring and seeking a DRG Coding Auditor CDI Remote $10K Sign On Bonus to join their team. Feel free to download the job details.
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