Gainwell Technologies
Gainwell Technologies is the nation’s leading provider of digital and cloud-enabled solutions across the human services and public health ecosystem. With a mission-driven approach, Gainwell serves clients in all 50 U. S. states, focusing on improving health outcomes and delivering intuitive, human-centered experiences. Their comprehensive suite of solutions includes Medicaid Enterprise modernization, data analytics, provider services, and pharmacy solutions, all designed to advance the future of healthcare and enhance community well-being.
Senior Associate, Coding Auditor
5 days ago
Gainwell Technologies
Gainwell Technologies is the nation’s leading provider of digital and cloud-enabled solutions across the human services and public health ecosystem. With a mission-driven approach, Gainwell serves clients in all 50 U. S. states, focusing on improving health outcomes and delivering intuitive, human-centered experiences. Their comprehensive suite of solutions includes Medicaid Enterprise modernization, data analytics, provider services, and pharmacy solutions, all designed to advance the future of healthcare and enhance community well-being.
📋 Description
• Responsible for performing coding reviews of medical records and/or other documentation • Access proprietary systems to audit medical records • Accurately document findings and providing policy/regulatory support • Perform audits of medical record documentation to determine the accuracy of codes • Adheres to official coding guidelines, coding clinics and regulatory guidelines • Draws on advanced ICD-10 coding expertise to substantiate conclusions • Utilizes HMS proprietary auditing systems with a high level of proficiency • Consistently achieves productivity and quality performance standards established by management • Actively cross-trains to perform reviews of multiple claim types • Assists management with training new Coding Auditors • Maintains current knowledge of coding guidelines and successfully completes required CEUs to maintain coding certification
🎯 Requirements
• One or more active professional credentials through AHIMA or AAPC: CPC, CCS, COC, RHIA, RHIT; required • 3+ years coding inpatient or outpatient claims; required • Demonstrated proficiency in medical record auditing and ICD-10 CM, ICD-10-PCS, APC, ASC, HCPCS, and CPT coding methodology • Demonstrates a thorough understanding of the APR-DRG, AP-DRG, and MS-DRG • Demonstrated experience in medical record coding and auditing • Demonstrated proficiency in computer skills and typing, i.e., Microsoft Windows, Outlook, Excel, Word, PowerPoint, Internet browsers and in virtual meeting tools i.e., Microsoft Teams, Zoom, etc.
🏖️ Benefits
• Benefits on first day of employment • Clear path advancement with training and leadership • Generous, flexible vacation policy • 401(k) employer match • Comprehensive health benefits • Educational assistance • Leadership and technical development academies
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