Performant Corporation is an Equal Opportunity Employer (Minorities/Females/Disabled/Veterans).

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Inpatient DRG Coding Auditor II (SCA)
Job Code:2017-50-4R-011
Location:Remote U.S. - Reports to San Angelo, TX Office
Status:Regular Full Time

Remote - Work From Home
(*must live in one of our approved states)

Performant Financial Corporation is a provider of technology workflow management solutions for various government, healthcare and financial services markets. We focus on audit and recovery services through our proprietary technology platform, combined with robust data analytics and experience gathered through decades of proven processes. 

Our base technology, workflow management processes and data management are flexible and extensible, as proven by our ability to service complex and competitive markets. Performant is committed to:
•Accurate auditing of payment streams
•Efficient recovery of past due receivables
•Intelligent management of financial assets

We provide services in highly regulated arenas in the public and private sector and we are committed to work in compliance with the laws and regulations that govern the industries we serve.

Why Performant?

-Competitive Hourly Rate
-Overtime and incentive opportunities based upon business activity
-Opportunity to make a direct contribution to the company’s bottom line
-Opportunity for career growth in our rapidly growing diversified healthcare business
-Flexible Work Schedule
-Variety in your work and opportunity to learn
-Medical, Dental, Vision, Life, AD&D, and more
-401K plan
-Accrued paid vacation
-Accrued paid sick
-Paid holidays
-$40/month internet reimbursement for remote workers
(*Must have acceptable home internet connection and meet requirements of Performant Teleworking Policies for remote work eligibility) 

What you will do:

•Objectively and accurately conduct coding reviews on medical records while meeting compliance, productivity and quality expectations.
•Appropriately refer reviews for clinical validation.
•Enter and update all contract and/or review findings and supporting documentation into the audit processing system.
•Maintain current knowledge of CMS and major payer coding and reimbursement policies.
•Maintain a current knowledge of Medicare and Commercial regulations, policies and procedures.
•Maintain coding certifications and other training (such as HIPAA, Fraud Waste and Abuse and Information Security) as required 
•Notify management of all correspondence indicating displeasure with the Recovery Agency
•Demonstrate Performant’s company core values as a member of the team in performing one’s role:
 -People - respect for others, diversity and professionalism in communications and conduct
 -Innovation - adaptability, and flexibility in applying skills in our dynamic business environment. Creativity and open minded in solving issues in our     teams, in development and delivery of our products, and for our clients.
 -Excellence – commitment to compliance, quality and achievement of business goals and results for our clients and for our business.
•Perform other duties as assigned required to meet business needs in a highly professional manner

Senior contributors may perform the following additional duties:
•Contribute to proof of concept development and data analysis of reports for potential edit development.
•Assist in developing material for training and facilitate or assist in MS-DRG audit training sessions.
•Assist in educating Performant team members on coding, policies, regulations, appeal strategies, etc. as needed.

Physical Requirements:

•i.e sit/stand/walk/ 8-10 hrs/day
•lift/carry/push/pull under 10lbs occasionally 
•Repetitive use of right/left hands
•Heavy keyboard and mouse utilization
•Some reaching and fine manipulation

Required Skills and Knowledge:

Possess knowledge of CMS rules and regulations
•Proficient in the use of CMS 1500/UB 04 forms

•Thorough working knowledge of CPT/HCPCs/ICD-9, MS-DRG coding (ICD-10 knowledge desired)
•Working knowledge of encoder
•Proven ability to review, analyze, and research coding issues
•Familiarity with interpreting electronic medical records (EHR)
•Basic understanding of accounting principles for accounts payable and receivable as it relates to medical billing

The Way You Work:

•Commitment to excellence, critical eye for quality and accuracy 
•Team spirit and the self-drive to meet and exceed productivity goals
•Enjoy spending time researching and giving attention to detail. 
•In depth knowledge of inpatient coding standards and systems, and adaptability applying those skills 
•Enjoy variety in your work and are willing to learn new systems and client requirements, anytime and anywhere
•Courteous, professional, and respectful attitude
•Adaptability of skills to handle any non-standard situations that may arise or apply skills in new ways as may be required to meet business needs
•Ability to multi-task effectively and work independently in a remote setting 
•Attention to detail
•Excellent written and verbal communication skills
•Typing skills, comfortable navigating and using desktop technology, as well as working knowledge of MS Office applications (Outlook, Word, Excel).

Education and Experience:
•Certification as a CPC, CPC-H, CPC-P, RHIA, RHIT, CCS, or CCS-P
•3+ years of DRG coding for hospital or other acute facility setting (inpatient/Skilled Nursing Facility)
Must have 2+ years of direct experience in medical chart review for Inpatient provider/claim types 
•Experience coding/auditing facility outpatient services desired, but not required
•Previous payer or provider experience in a claim processing, edit development, and/or coding and reimbursement policy desirable