Coding Quality Auditor - Remote

Coding Quality Auditor - Remote at Conifer Health Solutions

Conducts data quality audits of inpatient admissions and outpatient encounters to validate coding assignment is in compliance with official coding guidelines as supported by clinical documentation. Validates abstracted data elements that are integral for appropriate payment methodology.

• Consulting:
  Consults facility leaders and staff on best practices, methodology, and tools for accurately coding.
• Chart Analysis, IP/OP Coding Data Auditing and Validation:
  Reviews medical records for accurate assignment of diagnoses and procedures; adheres to AHIMA standards; validates abstracted data including discharge disposition for reimbursement/DRG.
• IP/OP Coding:
  Reviews records to accurately assign ICD-9-CM codes for diagnoses and procedures; abstracts required data elements including appropriate discharge disposition.
• Coding:
  Uses discretion and specialized coding training and experience to assign ICD-9, CPT-4 codes accurately.
• Abstracting:
  Reviews records to determine required abstracting elements including client‑specific discharge disposition.
• Coding Quality:
  Achieves accuracy and consistency in selection of principal/secondary diagnoses (incl. MCC & CC) and procedures; abstracts elements defined by SOW.
• CDI:
  Identifies documentation improvement opportunities and coding issues; communicates to appropriate personnel for resolution.
• Professional Development:
  Maintains current knowledge of AHA coding guidelines, CMS, ICD‑9/CPT updates; attends mandatory coding seminars, quarterly reviews, and coding updates conferences.

• Consistently code at 95% accuracy while maintaining client‑specified production standards.
• Pass coding test.
• Knowledge of medical terminology, ICD‑9‑CM and CPT‑4 codes.
• Detail‑oriented; ability to work independently.
• Proficiency in MS Office.
• Excellent interpersonal skills.
• Initiative and discipline in time management and assignment completion.
• Ability 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.

• Associate’s degree in a relevant field preferred, or equivalent combination of education and experience.
• Three years of coding experience including hospital and consulting background.

• AHIMA credentials or AAPC credentials.

• Bending, twisting, and lifting materials up to 25 lbs.
• Driving a vehicle to off‑site locations.
• Travel via plane, car, train, bus, or taxi.
• Ability to sit for extended periods.
• Efficient use of computer keyboard and mouse for coding assignments.

• Floats between clients as requested.
• Capacity to work independently in a virtual office or at hospital sites if required.

• Regular travel may be required.

As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help clients strengthen their financial and clinical performance, serve communities, and succeed at the business of healthcare. Conifer Health supports the transition from volume to value‑based care, enhances patient experience, and improves quality, cost and access to healthcare.

• Pay: $30.85 – $46.28 per hour. Compensation depends on location, qualifications, and experience.
• Position may be eligible for a signing bonus for qualified new hires, subject to employment status.
• Conifer observed holidays receive time and a half.
• Medical, dental, vision, disability, and life insurance.
• Paid time off (vacation & sick leave) – minimum 12 days per year, accrue approximately 1.84 hours per 40 hours worked.
• 401(k) 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: pet insurance, legal…