Inpatient Coding Quality Reviewer

Title: Inpatient Coding Quality Reviewer – Remote

Location: United States

Full-Time

Overview

As our Inpatient Coding Quality Reviewer, you will be responsible for reviewing inpatient-coded cases for coding completeness and accuracy. Identify potential coding and DRG errors, research appropriate guidelines to support recommended changes, and communicate the changes to the coder involved on a timely basis. Every day, you will provide expert coding advice to coding staff and relay needed coding educational topics to the Regional Manager, IP Coding Quality. To thrive you will have CCS, RHIA, or RHIT credentials and extensive knowledge of AHIMA Coding Guidelines and Coding Clinic and CMS guidelines.

About Us

At R1 RCM, we deliver innovative solutions by bringing together the best people and technologies that enable providers to simplify the healthcare experience. Our mission is to be the one trusted partner to manage revenue, so providers and patients can focus on what matters most. Our 22,000+ global associates are given valuable opportunities to contribute, innovate, and create meaningful work that makes an impact in the communities we serve around the world. Interested?

Here’s What You Can Expect

• Conduct daily pre-bill reviews of cases flagged by the PwC SMART coding quality monitoring software tool, and maintain required productivity standards and high-quality results.
• Review cases flagged by the coding quality software daily for multiple hospitals, including validating the completeness of documentation, identifying diagnoses and procedures that have been missed, proposing physician queries, and ensuring the accuracy of diagnoses, procedures, POA, discharge disposition, and DRG assignment.
• Perform retrospective coding quality reviews as requested.
• Follows, and maintains up-to-date knowledge of, industry coding and documentation guidelines (e.g., Official ICD-10 Coding and Billing Guidelines, Coding Clinic advice, R1 and Ascension coding policies and procedures, and AHIMA/ACDIS Query Guidelines) to maintain system-wide coding consistency and remain in compliance with governmental and other regulatory guidelines.
• Communicates audit findings with coders in a timely manner and supports the teams in effectively and efficiently addressing and resolving local coding issues.
• Serves as an inpatient coding expert and resource for the coding teams and other departments.

At R1, we are committed to promoting diversity, equity, and inclusion. We are proud to be an equal opportunity employer. We do not discriminate based on age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status regarding public assistance, veteran status or any other characteristic protected by federal, state, or local law. We are committed to providing a workplace free of harassment.

If you need assistance or accommodation to complete any part of the job application process, please contact us at 312-496-7709 or careers@r1rcm.com for assistance.

For this US-based position, the base pay range is $20.91 – $38.39. Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training.

Working in an evolving healthcare setting, we use our shared expertise to deliver innovative solutions. Our fast-growing team has opportunities to learn and grow through rewarding interactions, collaboration and the freedom to explore professional interests.

Our associates are given valuable opportunities to contribute, to innovate and create meaningful work that makes an impact in the communities we serve around the world. We also offer a culture of excellence that drives customer success and improves patient care. We believe in giving back to the community and offer a competitive benefits package including:

• Comprehensive Medical, Dental, Vision & RX Coverage
• Paid Time Off, Volunteer Time & Holidays
• 401K with Company Match
• Company-Paid Life Insurance, Short-Term Disability & Long-Term Disability
• Tuition Reimbursement
• Parental Leave

If you have a disability and require a reasonable accommodation to complete any part of the job application process, please contact us at 312-496-7709 for assistance.