Remote Optum Medical Coding Jobs in Bolingbrook, IL

Title:               Medical Coding Compliance Auditor
Location:        Remote USA
Position:         6-Month + Contract 

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Overview

TalentFish is casting a line for a Medical Coding Compliance Auditor to support a Medical Center in a fully remote capacity. *Candidates must be RHIA, RHIT, or CCS coding certified.

·      The Medical Coding Compliance Auditor will design and perform chart reviews, test the appropriateness of billing and documentation, and partner closely with the Clinical Documentation Integrity (CDI) team on reconciliation efforts.

·      This role requires hands-on experience with Epic Systems, 3M Encoder (Solventum Encoder), and SmarterDx software.

·      Candidates must have experience and ability to along with the judgment to identify risk, drive corrective action, and serve as a trusted resource on coding and compliance across the organization.

What You Bring To The Role

·      High School Diploma or GED required.

·      Coding certification required (e.g., RHIA, RHIT, and/or CCS).

·      3-5 years of senior-level coding audit experience, or five years of coding experience.

·      Experience with CDI reconciliation and comfort collaborating with the CDI team.

·      Ability to interpret and analyze electronic medical records, ancillary reports, and third-party payer guidelines.

·      Proficiency in Microsoft Office applications.

·      Excellent verbal and written communication skills, including with physicians and hospital department leadership.

·      Experience with hospital billing systems, including Epic and 3M Encoder (Solventum Encoder). SmarterDx experience a plus.

·      Query experience is valuable for this role.

·      Bachelor's degree in Health Information Technology, Healthcare Administration, Nursing, or a related field preferred.

Performance Expectations

·      Minimum of 8–10 SmarterDx accounts per day, depending on complexity.

·      95%+ coding accuracy rate.

·      Quality documentation and feedback on findings.

What You'll Do

·      Design and perform chart reviews, testing the appropriateness of billing and documentation.

·      Prepare and present reports of findings with recommendations for corrective action as needed.

·      Identify and prioritize risk issues, working as part of a team on projects.

·      Monitor the Medical Center's compliance with governmental regulations through recurring compliance reviews.

·      Research government billing regulations, third-party payer guidelines, prospective payment systems, and ICD-10-CM/PCS, CPT, and HCPCS coding guidelines.

·      Maintain a current understanding of regulatory issues through seminars, training courses, and regulatory literature.

·      Assist with the development of the annual departmental work plan.

·      Design and implement individualized documentation and coding improvement activities for physicians and administrators.

·      Act as a resource and educator on documentation improvement projects.

·      Serve as the internal liaison for the Medical Center on coding and compliance questions and concerns.

·      Facilitate compliance initiatives through education, newsletters, and training sessions.

·      Assist in the development, coordination, and maintenance of all elements of the Compliance Education Program.

·      Assist in updates to Compliance manuals and websites.

·      Other duties and projects as assigned.

Compensation and Employment
This role requires authorization to work in the U.S. without current or future visa sponsorship. The expected hourly rate for this position is $40-45 per hour W2, depending on experience and qualifications. This role also qualifies for comprehensive benefits such as medical, dental and vision insurance and paid time off (PTO). TalentFish is committed to pay transparency and equal opportunity. The salary range provided is in compliance with applicable state and federal regulations. All offers are contingent upon the completion of a background check, which may include but is not limited to reference checks, education verification, employment verification, drug testing, criminal records checks, and any required certifications or compliance requirements based on the end client's background check policies and applicable laws.
TalentFish is an employee-owned company pioneering a new realm in talent acquisition. We are redefining IT staffing by evolving AI, video screening, and our unique platform. TalentFish focuses on providing the best employee, consultant, and client experience possible. TalentFish is an Equal Opportunity Employer; we embrace and encourage diversity.

TalentFish is an employee-owned company pioneering a new realm in talent acquisition. We are redefining IT staffing by evolving AI, video screening, and our unique platform. TalentFish focuses on providing the best employee, consultant, and client experience possible. At TalentFish we are an Equal Opportunity Employer; we embrace and encourage diversity.