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Stout Risius Ross LLC

Inpatient Coding, Forensics and Compliance - Dispu

Career Insights for Clinical Auditor / Utilization Reviewer

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Based on Illinois data

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What they do

A Clinical Auditor or Utilization Reviewer reviews the efficiency of healthcare delivery. Individuals tend to have had experience as a registered nurse or other healthcare delivery roles before transferring into this quality review role.

$93,772 / year median in Illinois

-10% projected decline

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Job Description

at Stout Risius Ross LLC in Chicago, Illinois, United States Job Description At Stout, we're dedicated to exceeding expectations in all we do - we call it Relentless Excellence . Both our client service and culture are second to none, stemming from our firmwide embrace of our core values: Positive and Team-Oriented, Accountable, Committed, Relationship-Focused, Super-Responsive, and being Great communicators. Sound like a place you can grow and succeed? Read on to learn more about an exciting opportunity to join our team. Impact You'll Make Contribute to complex healthcare consulting engagements involving coding audits, disputes, claims analysis, and investigations. Deliver accurate coding analyses that inform client decisions, regulatory responses, and litigation support. Identify billing, coding, reimbursement, and compliance risks. Support defensible findings through detailed documentation and analysis. Apply inpatient coding and reimbursement expertise to deliver exceptional client service. What You'll Do Review inpatient medical records for
ICD-10-CM/PCS
coding accuracy. Analyze coding, billing, and reimbursement practices. Support forensic analyses and compliance reviews. Assist with audits, investigations, and litigation support. Evaluate MS-DRG, APR-DRG, and APC assignments. Prepare reports and client-ready deliverables. Monitor coding trends and regulatory updates. Collaborate with clients, legal counsel, and engagement teams. What You'll Bring Bachelor's degree in Health Information Management or related field, or equivalent experience. Five years of acute-care inpatient coding experience. Active CCS, CIC, RHIT, or RHIA credential. Knowledge of
MS-DRG, APR-DRG, APC
reimbursement methodologies. Experience with coding audits and denials preferred. Knowledge of CMS, HIPAA, and the False Claims Act. Strong Microsoft Office, analytical, and communication skills. How You'll Thrive Interpret complex clinical and coding information accurately. Collaborate effectively with clients and colleagues. Take ownership and deliver high-quality work. Adapt to evolving regulations and priorities. Demonstrate integrity and embody Stout's core values: Positive and Team-Oriented, Accountable, Committed, Relationship-Focused, Super-Responsive, and Great Communicators while delivering Relentless Excellence. Why Stout? At Stout, we offer a comprehensive Total Rewards program with competitive compensation, benefits, and wellness options tailored to support employees at every stage of life. We foster a culture of inclusion and respect, embracing diverse perspectives and experiences to drive innovation and success. Our leadership is committed to inclusion and belonging across the organization and in the communities we serve. We invest in professional growth through ongoing training, mentorship, employee resource groups, and clear performance feedback, ensuring our employees are supported in achieving their career goals. Stout provides flexible work schedules and a discretionary time off policy to promote work-life balance and help employees lead fulfilling lives. Learn more about our benefits and commitment to your success.
https:
//www.stout.com/en/careers/benefits The specific statements shown in each section of this description are not intended to be all-inclusive. They represent typical elements and criteria necessary to successfully perform the job. Stout is an Equal Employment Opportunity.

All qualified applicants will receive consideration for employment on the basis of valid job requirements, qualifications and merit without regard to race, color, religion, sex, national origin, disability, age, protected veteran status or any other characteristic protected by applicable local, state or federal law. Stout is required by applicable state and local laws to include a reasonable estimate of the compensation range for this role. The range for this role considers several factors including but not limited to prior work and industry experience, education level, and unique skills. The disclosed range estimate has not been adjusted for any applicable geographic differential associated with the location at which the position may be filled. It is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is $74,000.00 - $135,000.00 Annual. This role is also anticipated to be eligible to participate in an annual bonus plan. Information about benefits can be found here - https://www.stout.com/en/careers/benefits. To view full details and how to apply, please login or create a Job Seeker account