Full-Time

Hospital Coding Auditor

Posted on 12/3/2024

R1 RCM

R1 RCM

10,001+ employees

Revenue cycle management solutions for healthcare

Enterprise Software
Healthcare

Compensation Overview

$43.9k - $67.1kAnnually

+ Bonus

Junior, Mid

Remote in USA

Category
Healthcare Administration & Support
Medical, Clinical & Veterinary
Requirements
  • CPC, CCS, CPC-H (COC), CPMA, CIC, RHIA, RHIT and/or CCS-P certification
  • Experience in billing, charge documentation, charge audit or charge capture activities, or other functions related to revenue cycle activities.
  • Experience coding multi-specialties preferred that may include trauma, orthopedics, cardiology, interventional radiology, and neurology.
  • Must possess a demonstrated knowledge of clinical processes; clinical coding (CPT, HCPCS, ICD-10, revenue codes, status indicators, and modifiers), charging processes and audits.
  • Knowledge of CMS guidelines, Ambulatory Payment Classification, and Outpatient Prospective Payment System, reimbursement structures and prebill edits including Outpatient Coding Edits/Correct Coding Initiative edits preferred.
  • Experience with encoder technology and electronic medical record systems.
  • Ability to work in a flexible environment, adapting to changing priorities.
  • Excellent organizational skills and strong attention to detail.
Responsibilities
  • Review hospital charges against medical record and all applicable documentation to determine appropriate code assignments on services provided (CPT/HCPCS codes)
  • Understand billing and coding requirements for government and commercial payers.
  • Abstract statistical data from the patient record and enter information following facility guidelines.
  • Follow all HIPAA regulations and uphold a higher standard around privacy requirements.
  • Maintain at least a 95% accuracy rate.
  • Maintain productivity standards, tracking logs and deadlines.

R1 RCM provides Revenue Cycle Management (RCM) solutions to healthcare providers, including hospitals and physician groups. The company uses advanced technology to streamline financial and administrative processes, helping clients reduce costs and improve patient experiences. R1 RCM differentiates itself by forming long-term partnerships with healthcare organizations and focusing on performance-based incentives. The main goal is to enhance financial outcomes and patient satisfaction by simplifying the revenue cycle.

Company Stage

IPO

Total Funding

N/A

Headquarters

Murray, Utah

Founded

2003

Growth & Insights
Headcount

6 month growth

11%

1 year growth

24%

2 year growth

36%
Simplify Jobs

Simplify's Take

What believers are saying

  • Increased telehealth adoption boosts demand for RCM solutions handling virtual care billing.
  • AI integration in RCM processes enhances automation of complex billing tasks.
  • Value-based care models create opportunities for RCM solutions aligning financial incentives with outcomes.

What critics are saying

  • Inconsistencies in service turnaround times and accuracy may affect client satisfaction.
  • Acquisition by TowerBrook and CD&R could disrupt operations and client relationships.
  • High competition in physician advisory services threatens R1 RCM's market position.

What makes R1 RCM unique

  • R1 RCM specializes in end-to-end Revenue Cycle Management for healthcare providers.
  • The company leverages advanced technology to streamline financial and administrative processes.
  • R1 RCM focuses on improving patient experience and financial performance for healthcare clients.

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