Livanta
REVIEWER (Coding Expert Reviewer/Auditor)
Livanta, Baltimore, Maryland, United States, 21276
SummarySubject matter expert in clinical documentation review, clinical data abstraction, clinical coding, auditing, and variables impacting payment methodologies that are based in medical record documentation. Performs compliance audits employing specified protocols and criteria; conducts data abstraction and collection activities; interprets and applies coverage and payment policies, edits, and certification and regulatory requirements for medical necessity and other audit decisions; classifies findings and provides commentary for clinical data, qualitative, and statistical analyses; records rationale for and basis of audit findings using proper grammar and communication methods; writes reports in accordance with company requirements. Provides feedback to hospitals concerning audit findings and discusses rationales for audit decisions.ResponsibilitiesPrimary Duties:
Performing audit functions for the identified encounters in a timely and accurate manner.Generating well-written deliverables and audit work papers.Outstanding verbal communication skills.Outstanding communications and interactions with hospital and client personnel.Essential Skills:
2 or more years of relevant experience performing complex coding; quality assurance, training, appeals, and/or auditing services involving ICD-10-CM/PCS, CPT/HCPCS, DRG/APRDRG, and/or other coding, classification, and/or payment systems pertinent in the healthcare industry, including but not limited to, State of Maryland, in particular.Ability to research, determine, and apply solutions.Ability to communicate effectively with other reviewers and clients to ensure quality of audit findings and acceptance and understanding of findings.Practical knowledge of and ability to comply with Health Insurance Portability and Accountability Act (HIPAA), and other laws and regulations pertaining to confidentiality, privacy of protected health information, personally identifiable information, and other sensitive information.Practical knowledge of and ability to comply with system and information security requirements.Qualifications and RequirementsEssential Education:
Bachelor's degree in a related discipline or specialized licensure, certification, or accreditation.
Required License or other Special Certifications/Accreditations:
RHIA, RHIT, RN, or MD; CCS, CCS-P, CPC, CRCDesired CharacteristicsOrganizational "Fit" Considerations:The ideal candidate will be a good team player and able to work in a fast-paced environment. The ability to work weekends may be required from time to time, to ensure that timecards are ready for payroll processing.Posted:
5/30/2024 1:26:05 PM
Locations:
MarylandAnnapolis Junction, MD 20701Career Level:
Professional
Department:
Medical Professionals
Clearance Requirement:
Not applicable
Telecommuting options:
Telecommuting only
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
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Performing audit functions for the identified encounters in a timely and accurate manner.Generating well-written deliverables and audit work papers.Outstanding verbal communication skills.Outstanding communications and interactions with hospital and client personnel.Essential Skills:
2 or more years of relevant experience performing complex coding; quality assurance, training, appeals, and/or auditing services involving ICD-10-CM/PCS, CPT/HCPCS, DRG/APRDRG, and/or other coding, classification, and/or payment systems pertinent in the healthcare industry, including but not limited to, State of Maryland, in particular.Ability to research, determine, and apply solutions.Ability to communicate effectively with other reviewers and clients to ensure quality of audit findings and acceptance and understanding of findings.Practical knowledge of and ability to comply with Health Insurance Portability and Accountability Act (HIPAA), and other laws and regulations pertaining to confidentiality, privacy of protected health information, personally identifiable information, and other sensitive information.Practical knowledge of and ability to comply with system and information security requirements.Qualifications and RequirementsEssential Education:
Bachelor's degree in a related discipline or specialized licensure, certification, or accreditation.
Required License or other Special Certifications/Accreditations:
RHIA, RHIT, RN, or MD; CCS, CCS-P, CPC, CRCDesired CharacteristicsOrganizational "Fit" Considerations:The ideal candidate will be a good team player and able to work in a fast-paced environment. The ability to work weekends may be required from time to time, to ensure that timecards are ready for payroll processing.Posted:
5/30/2024 1:26:05 PM
Locations:
MarylandAnnapolis Junction, MD 20701Career Level:
Professional
Department:
Medical Professionals
Clearance Requirement:
Not applicable
Telecommuting options:
Telecommuting only
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
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