DRG Validation Auditor

Are you passionate about the patient experience? At HCA Healthcare, we are committed to caring for patients with purpose and integrity. We care like family!

About the role

As a work-from-home Inpatient Coding Auditor, you will perform internal quality assessment reviews on Health Information Management Service Center (HSC) coders to ensure compliance with national coding guidelines, the HSC coding policies, and the Company coding policies for complete, accurate, and consistent coding. This ensures appropriate reimbursement and data integrity. You will review outcomes and communicate them to the HSC team to improve the accuracy, integrity, and quality of patient data, minimize variation in coding practices, and enhance the quality of physician documentation within medical records to support code assignments.

Responsibilities

• Leads, coordinates, and performs all functions of quality reviews (routine, pre-bill, policy-driven, and incentive-plan-driven) for inpatient and/or outpatient coding across multiple HSCs
• Assists in ensuring HSC coding staff adherence with coding guidelines and policy
• Demonstrates and applies expert-level knowledge of medical coding practices and concepts
• Participates in special reviews or projects
• Maintains or exceeds 95% productivity standards
• Maintains or exceeds 95% accuracy
• Meets all educational requirements as stated in current Company policy
• Reviews all official data quality standards, coding guidelines, Company policies and procedures, and clinical/medical resources to assure coding knowledge and skills remain current

Qualifications

• High school diploma and/or GED (preferred)
• Undergraduate degree in HIM/HIT (preferred)
• Minimum of 3 years acute care inpatient/outpatient coding experience (preferred)
• Minimum of 3 years coding auditing/monitoring experience (strongly preferred)
• RHIA, RHIT, and/or CCS certification (preferred)

Benefits

Parallon offers a total rewards package that supports the health, life, career, and retirement of our colleagues. The available plans and programs include:

• Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health, and telemedicine services
• Wellbeing support, including free counseling and referral services
• Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage, and leaves of absence
• Savings and retirement resources, including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support, and financial wellbeing counseling
• Education support through tuition assistance, student loan assistance, certification support, dependent scholarships, and a partnership with Galen College of Nursing
• Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection, and consumer discounts

Note: Eligibility for benefits may vary by location.