Hospital Coding Auditor

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 Revenue Integrity Facility Coding Auditor, you will review hospital charges against medical record and all applicable documentation to determine appropriate code assignments on services provided (CPT/HCPCS codes). The Auditor must have a comprehensive understanding of medical terminology, coding, contractual agreements, and various payment methodologies.  This position requires good time management skills and the ability to work independently. 

Here’s what you will experience working as a Revenue Integrity Facility Coding Auditor: 

• 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. 

To be successful in this role, you must have:

• 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

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.

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To learn more, visit: R1RCM.com

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