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Job Title: Inpatient Coding Auditor - DRG ValidationLocation: RemoteSalary: $33.00 – $50.00 per hourSchedule: Full-timeTravel: Initial onsite orientation during the first week with occasional additional travel as neededJob Overview:We are seeking an experienced Inpatient Coding Auditor specializing in DRG validation to review medical records and ensure the accuracy of Diagnosis Related Group assignments. The ideal candidate has strong inpatient coding experience, deep knowledge of DRG assignment, and the ability to analyze clinical documentation to ensure accurate coding and reimbursement.

HOUR

Job Title: Inpatient Coding Auditor - DRG ValidationLocation: RemoteSalary: $33.00 – $50.00 per hourSchedule: Full-timeTravel: Initial onsite orientation during the first week with occasional additional travel as neededJob Overview:We are seeking an experienced Inpatient Coding Auditor specializing in DRG validation to review medical records and ensure the accuracy of Diagnosis Related Group assignments. This role focuses on validating inpatient coding, evaluating clinical documentation, and ensuring compliance with CMS regulations and coding guidelines.The ideal candidate has strong inpatient coding experience, deep knowledge of DRG assignment, and the ability to analyze clinical documentation to ensure accurate coding and reimbursement.Key Responsibilities:Review inpatient medical records to validate accurate DRG assignment and coding complianceAnalyze patient charts to identify discrepancies in coding or clinical documentationEnsure coding accuracy according to CMS regulations and industry coding guidelinesConduct second-level reviews of DRGs, discharge dispositions, and Present on Admission (POA) indicators prior to billingCollaborate with coding teams and clinical staff to resolve documentation and coding questionsParticipate in coding audits and quality improvement initiativesResearch and respond to coding or documentation denials related to DRG assignmentsProvide guidance and education to coding staff regarding documentation and coding best practicesSupport regulatory compliance and internal audit activitiesRequired Qualifications:Minimum of 5 years of inpatient coding experienceExperience with DRG validation, auditing, or coding quality reviewStrong understanding of clinical documentation and coding compliance standardsAbility to work independently in a remote environmentStrong analytical and communication skillsEducation:Associate's or Bachelor's degree in Health Information Management or a related field preferredRequired Certification:Candidates must hold at least one of the following credentials:RHIARHITCCSCPCCCS-PTechnical Knowledge:Strong understanding of DRG assignment and coding guidelinesFamiliarity with UB-04 billing standards and CMS regulationsExperience reviewing clinical documentation for coding accuracyBenefits:Competitive hourly compensationComprehensive medical, dental, and vision coverageThree weeks of paid vacationFully remote work environmentOpportunity to work in a specialized coding and compliance role within healthcare operationsPandoLogic. Keywords: Medical Coder, Location: Brunswick, GA - 31524

Care Career_IDR Healthcare

Inpatient Coding Auditor - DRG Validation (Remote)

Analysis Skills

Auditing

Billing

Clinical Study Publications

Content Management Systems (CMS)

Diagnosis-Related Group (DRG)

Documentation

Health Information Management

Healthcare

Internal Audit

Maintain Compliance

Medical Coding

Medical Records

Patient Care

Patient Charts

Quality Management

Regulations

Regulatory Compliance

Reimbursement

Work From Home

Pandologic

To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria: + At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it.

YEAR

Become a part of our caring community and help us put health first The Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. The Coding Educator 2 will be responsible for arranging educational sessions with assigned providers aimed at quality of care and documentation improvements. + Identify educational needs based on reports + Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. + Provider onsite education, based on business needs + Collaboration with other market provider facing role + Utilize data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. + Analyze coding audit results and other relevant data to develop data-driven educational materials and interventions. + Participate in cross-functional teams to improve documentation, data integrity, and workflow processes Use your skills to make an impact Required Qualifications + AHIMA or AAPC CPC (Certified Professional Coder) Certification + 3 or more years of medical coding education and/or auditing in a healthcare setting experience + Proficiency with data analytics tools (such as Excel, Power BI, or similar) and experience in interpreting large data sets + Experience with speaking with leadership, webinars public speaking and/or presentation skills with healthcare providers + Risk Adjustment knowledge + Familiar with coding guidelines + Live in South Carolina, North Carolina or Georgia Preferred Qualifications + Bachelor's Degree + CRC -Certified Risk Adjustment Coder + Experience interacting with healthcare providers + Strong technical knowledge of all Microsoft Office applications + Strong attention to detail and exceptional follow up skills + Valid Driver's license and reliable transportation + Medicare Risk Adjustment knowledge Additional Information Work at home - with ability to travel (up to 5%) to surrounding provider offices As part of our hiring process, we will be using an exciting interviewing technology provided by HireVue, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making. If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes. If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews. Work at Home Guidance To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria: + At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested + Satellite, cellular and microwave connection can be used only if approved by leadership + Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. + Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job. + Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Internal- If you have additional questions regarding this role posting, please send them to the Ask A Recruiter persona by visiting go/vivaengage and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker. #LI-BB1 Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $59,300 - $80,900 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. ​ Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.

Humana

Coding Educator

FEED

Our Inpatient Rehabilitation Hospital is committed to providing exceptional and compassionate care to best address the medical, physical, emotional, and vocational challenges for individuals with brain injuries, spinal cord injuries, neurological disorders, orthopedic issues, amputation, and multiple traumas. Assists the PPS Manager with PPS functions including but not limited to: IRF-PAI data collection, medical coding, IRF-PAI transmittals, and IRF-PAI correction.

Overview:
UF Health Rehabilitation Hospital - NorthAffiliation with Select Medical Position: PPS Coordinator - PRN Schedule: Per-Diem/PRN/As Needed  Our Inpatient Rehabilitation Hospital is committed to providing exceptional and compassionate care to best address the medical, physical, emotional, and vocational challenges for individuals with brain injuries, spinal cord injuries, neurological disorders, orthopedic issues, amputation, and multiple traumas. Why Join Us:<ul><li>Start Strong: Extensive orientation program to ensure a smooth transition into our setting.</li><li>Opportunity for Advancement: Demonstrate your skills and dedication which could lead to potential full-time opportunities</li><li>Foster Well-being: We offer benefits which support the financial, work/life and emotional well-being of you and your family members.  Part time/Per Diem positions are eligible for 401k based on reaching 1,000 hours within their first anniversary or subsequent calendar year. </li><li>Your Impact Matters: Join a team of over 44,000 committed to providing exceptional patient care</li></ul>

Responsibilities:
<ul><li>Coordinates the data collection on the Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI)</li><li>Ensures the presence of supporting documentation, and provides staff education to ensure compliance with CMS guidelines.</li><li>Coordinates all efforts for immediate issue resolution concerning Section GG scoring.</li><li>Conducts ongoing review of IRF-PAI related data, and assists the PPS Manager with IRF-PAI completion.</li><li>Participates in performance improvement initiatives and staff education to ensure that staff is provided the tools and support they need to accurately document scores and co-morbidities according to CMS standards and guidelines for completion of the IRF PAI.</li><li>Assists the PPS Manager with PPS functions including but not limited to: IRF-PAI data collection, medical coding, IRF-PAI transmittals, and IRF-PAI correction.</li></ul>

Qualifications:
Minimum Qualifications<ul><li>Current state licensure in nursing (RN) or allied health profession (PT, OT, SLP) required</li><li>Minimum of two years experience in rehabilitation or a closely related field required</li><li>Previous experience required </li></ul>Preferred Qualifications<ul><li>Experience with ICD 10 coding preferred</li><li>Experience with IRH-PPS preferred</li></ul>

Additional Data:
Equal Opportunity Employer/including Disabled/Veterans

UF Health Rehabilitation Hospital - North

PPS Coordinator - PRN/per-diem

Business Performance Management

Data Collection

Hospital

ICD-10

Neurology

Neurotrauma (Traumatic Brain Injury)

Nursing Credentials

Organizational Skills

Orthopedics

Patient Assessment

Precise Positioning Service (PPS)

Problem Solving Skills

Registered Nurse (RN)

Spinal Cord Injury

Staff Training

Training/Teaching

[AW]-iCims

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Inpatient Coding Auditor - DRG Validation (Remote)Care Career_IDR Healthcare

Coding EducatorHumana

PPS Coordinator - PRN/per-diemUF Health Rehabilitation Hospital - North

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