CRC/DRG Coding Auditor - Remote jobs in United States
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Conifer Health Solutions · 21 hours ago

CRC/DRG Coding Auditor - Remote

Conifer Health Solutions is a healthcare company focused on improving patient outcomes and operational efficiencies. They are seeking a CRC/DRG Coding Auditor to conduct data quality audits of inpatient admissions and outpatient encounters to ensure compliance with coding guidelines and validate abstracted data elements for payment methodology.

Health Care
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H1B Sponsor Likelynote

Responsibilities

Consults facility leaders and staff on best practices, methodology, and tools for accurately coding
Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures
Adheres to Standards of Ethical Coding (AHIMA)
Reviews claim to validate abstracted data including but limited to discharge disposition which impacts facility reimbursement and/or MS-DRG assignment
Reviews medical records to determine accurate required abstracting elements (facility/client/payer specific elements) including appropriate discharge disposition
Reviews medical records for the determination of accurate assignment of all documented ICD-9-CM codes for diagnoses and procedures
Abstracts accurate required data elements (facility/client specific elements) including appropriate discharge disposition
Uses discretion and specialized coding training and experience to accurately assign ICD-9, CPT-4 codes to patient medical records
Reviews medical records to determine accurate required abstracting elements (client specific elements) including appropriate discharge disposition
Demonstrates ability to achieve accuracy and consistency in the selection of principal and secondary diagnoses (including MCC & CC) and procedures
Demonstrates ability to achieve accuracy and consistency in abstracting elements defined by SOW
Identifies and communicates documentation improvement opportunities and coding issues (lacking documentation, physician queries, etc.) to appropriate personnel for follow-up and resolution
Stays current with AHA Official Coding and Reporting Guidelines, CMS and other agency directives for ICD-9-CM and CPT coding
Attends mandatory coding seminars on annual basis (IPPS and OPPS, ICD-9-CM and CPT updates) for inpatient and outpatient coding
Quarterly review of AHA Coding Clinic
Attends Quarterly Coding Updates and all coding conference calls

Qualification

ICD-9-CM codingCPT-4 codingAHIMA standardsMedical terminologyMS OfficeDisease pathophysiologyMSDRG classificationAPC classificationDisciplineInterpersonal skillsTime managementInitiativeDetail orientedIndependent work

Required

Ability to consistently code at 95% accuracy and quality while maintaining client specified production standards
Must successfully pass coding test
Knowledge of medical terminology, ICD-9-CM and CPT-4 codes
Must be detail oriented and have the ability to work independently
Computer knowledge of MS Office
Must display excellent interpersonal skills
The coder should demonstrate initiative and discipline in time management and assignment completion
The coder must be able to work in a virtual setting under minimal supervision
Intermediate knowledge of disease pathophysiology and drug utilization
Intermediate knowledge of MSDRG classification and reimbursement structures
Intermediate knowledge of APC, OCE, NCCI classification and reimbursement structures
Associates degree in relevant field preferred or combination of equivalent of education and experience
Three years coding experience including hospital and consulting background
RN
AHIMA and/or AAPC approved credentials

Benefits

Medical, dental, vision, disability, life, and business travel insurance
Paid time off (vacation & sick leave) – min of 12 days per year, accrued accrue at a rate of approximately 1.84 hours per 40 hours worked.
401k with up to 6% employer match
10 paid holidays per year
Health savings accounts, healthcare & dependent flexible spending accounts
Employee Assistance program, Employee discount program
Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance.
For Colorado employees, Conifer offers paid leave in accordance with Colorado’s Healthy Families and Workplaces Act.

Company

Conifer Health Solutions

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Conifer Health Solutions is a healthcare services company helping organizations strengthen their financial performance

H1B Sponsorship

Conifer Health Solutions has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (5)
2024 (3)

Funding

Current Stage
Late Stage

Leadership Team

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Brian Murkowski
HR Business Partner
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David Buchanan
Talent Acquisition Partner
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Company data provided by crunchbase