Coding Integrity Specialist Jobs (NOW HIRING)

R1 is the leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry's most advanced technology platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration.

As our Coding Integrity Specialist, you will works with theCodingIntegrityManager and Director of CodingOperationstoestablishopen lines of communicationregardingpotential coding quality concerns. Every day you will, leads, coordinates, and performs coding quality reviews. To thrive in this role you must, strong analytical skills and ability tocomprehendand analyzelarge quantitiesof operational data, ability to review complex medical recordsand strong ability to multi-taskand prioritize work assignments

Here's what you will experience working as a Coding Integrity Specialist:

• Conductcomplex coding reviews related to reimbursement, public reporting,andpay for performance.

• Collaborateswiththe CDIteam,assistingwith the resolution of documentation inconsistencies,DRG variances,andCDI and internal operations to ensure KPIs, SLA, RIS, and DNFB requirements.

• Ensuresthat theDRGorreimbursementaccurately reflects the services/utilizationof resourcesprovided by the hospitaltooptimizetheimpactsofcase mix indexreporting.

• Collaborateswith hospital/clientleadership tovalidateproper coding forappropriate reimbursementfor specific service lines and technology whichassistshospitals indeterminingif that technology is a positive return on investment

• Performs second level focusedpre-billand post-billaccountreviewsto ensureaccuratecoding, review for quality and risk (HAC, PSI, Mortalities, Core Measures and CMS Initiatives)andescalation for final reviewwhich may include approval forwrite-off.

• Conductcomplex360coding reviewswhichincludeidentificationand correction of coding,andtrendingfor the following issues:documentation,codingdenialsi.emedical necessity,billing,andcharging

• Evaluateforcodingaccuracy/specificitytoassistwith preventingpossible lossof revenue for the hospitalrelated tovalue-based payment programsandpublic reporting

• Provide education/feedbackto coders/coding managersregardingcoding correctionsvia automated individualnotifications

• Identifycoding trends that require formal educationby the R1 Education and Training teamandworkwithintegration teams and project management teams to test and give feedbackon updates to systems and mappings

• Performad hoc,CloudmedDRGValidationReviewsor requests based on client specific wants or needs.

Required Skills:

• Bachelor's orassociate's degreein HIM related fieldsor CCScredentialisrequired.

• Minimum5 years of inpatient coding.

The healthcare system is always evolving - and it's up to us to use our shared expertise to find new solutions that can keep up. On our growing team you'll find the opportunity to constantly learn, collaborate across groups and explore new paths for your career.

Our associates are given the chance to contribute, think boldly and create meaningful work that makes a difference in the communities we serve around the world. We go beyond expectations in everything we do. Not only does that drive customer success and improve patient care, but that same enthusiasm is applied to giving back to the community and taking care of our team - including offering a competitive benefits package.

R1 RCM Inc. ("the Company") is dedicated to the fundamentals of equal employment opportunity. The Company's employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person's 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 with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, the Company is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories.

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.

CA PRIVACY NOTICE: California resident job applicants can learn more about their privacy rights California Consent

To learn more, visit: R1RCM.com

Visit us on Facebook