Sr Auditor Tl, Clinical Validation Position Available In Philadelphia, Pennsylvania

Location:

REMOTE Salary:

$30.00 USD Hourly – $45.00

USD Hourly Description:

Judge Healthcare is seeking a Sr. Coding & Clinical Chart Validation (Inpatient) Auditor!!

Employment Type:

Temp to

Hire Location:

Fully Remote Training Hours:

8:00 AM – 4:00

PM EST Work Hours:

Full Time, 40 hrs.’ per week in between 6a-6p EST We are seeking an experienced Auditing Specialist to focus on Coding & Clinical Chart Validation for our Inpatient Audits. The ideal candidate possesses a combination of clinical expertise (nursing) and/or coding/auditing experience, particularly in Inpatient DRG/APR-DRG and episode of care disciplines. This role involves auditing inpatient claims and documenting results, with an emphasis on clinical review, coding accuracy, and evaluating treatment settings and services. Key Responsibilities Claims Analysis and Auditing (Primary Role) Conduct medical chart coding reviews and audits, leveraging advanced ICD-10 coding principles, clinical guidelines, and industry knowledge. Perform comprehensive reviews of medical records and episodes of care independently. Effective Use of Audit Tools Utilize proprietary auditing systems to generate audit determinations and documentation. Demonstrate a high level of proficiency in audit tools. Meet Standards of Productivity Achieve and maintain production goals set by the audit operations team. Maintain Accuracy and Quality Ensure adherence to accuracy and quality benchmarks for auditing, claim validation, and documentation. Discover New Opportunities Identify claims outside of predefined concepts for potential recovery opportunities. Develop high-value concepts, process improvements, and innovative tools. Complete Assigned Duties Fulfill responsibilities outlined in the annual performance plan and contribute to special projects as needed. Requirements Education At least one of the following: Associate or Bachelor’s Degree in Nursing (Active/Unrestricted License) Associate or Bachelor’s Degree in Health Information Management (RHIA or RHIT) Certifications At least one of the following: RHIA or RHIT CPC or COC Inpatient Coding Credential (CCS, CIC, CDIP, or CCDS) Experience 1.5+ years of experience with ICD-9/10CM, MS-DRG, AP-DRG, and APR-DRG. Broad knowledge of medical claims billing/payment systems, coding terminology, and payer reimbursement policies. Expertise in official coding guidelines, coding clinic determinations, CMS regulations, and compliance standards. Proficiency in Microsoft Office Suite (Word, Excel, Access, Teams) and other applications. Strong verbal and written communication skills. By providing your phone number, you consent to: (1) receive automated text messages and calls from the Judge Group, Inc. and its affiliates (collectively “Judge”) to such phone number regarding job opportunities, your job application, and for other related purposes. Message & data rates apply and message frequency may vary. Consistent with Judge’s Privacy Policy, information obtained from your consent will not be shared with third parties for marketing/promotional purposes. Reply STOP to opt out of receiving telephone calls and text messages from Judge and HELP for help.

Contact:

croche01@judge.com This job and many more are available through The Judge Group. Find us on the web at www.judge.com