Key Facts

Remote From:

Category: Auditor

Full time

English

Hard Skills

ICD Coding (ICD-9/ICD-10) Electronic Medical Record Clinical Auditing Clinical Documentation Regulatory Compliance Reimbursement Regulations Web Tools Occupational Therapy Patient Preparation Speech-Language Pathology +2 more

Other Skills

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Communication
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Analytical Skills
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Teamwork
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Detail Oriented

Roles & Responsibilities

Current and valid PHRN license
At least 6 months of work experience in a clinical setting
Knowledge of EMR/EHR (Electronic Medical Records/Electronic Healthcare Records)
Strong knowledge of prehospital patient care protocols, standards, and regulatory requirements

Requirements:

Review ICD-10 codes to ensure correct clinical category mapping
Identify missed reimbursement opportunities across PT/OT, SLP, NTA, Nursing, and Functional Scoring
Ensure therapy services and clinical documentation are properly aligned
Utilize CMS tools, the RAI Manual, and internal protocols to maintain regulatory compliance

iSTA Solutions

About iSTA Solutions

Welcome to Ista Solutions, your go-to remote staffing solutions provider. We understand the challenges businesses face when managing their workflows and finding the right people to execute their vision. That's why we exist—to be your dedicated partner in growth. Here are some reasons why our services are a must-have for your business: -We provide tailor-made workflow solutions that cater to your unique business requirements, helping you streamline your operations, reduce the turnaround time, and maximize efficiency. -Our agents are skilled, experienced, and solely focused on your company. They are trained to deliver outstanding results while working closely with your team and adhering to your company's culture. -We leverage our global resources to provide comprehensive support for your business, including technical assistance, billing services, and recruitment. This way, you can focus on growing your business while we take care of the back-end operations. At Ista Solutions, we believe in the power of building strong relationships with our clients. We strive to be your long-term partner in success, providing ongoing support and guidance to help you navigate through any challenges that may arise. We understand the importance of transparency and honesty in business. That's why we pride ourselves on being open, ethical, and straightforward in all our client interactions. Without Ista, healthcare companies commonly face: -Overburdened workforce -Increased demand for productivity -The need to reduce operational costs -The lack of specialized expertise in-house -Difficulty finding reliable remote staff We know that these problems can have a big effect on the growth and success of your business, which is why we're here to offer you complete remote staffing solutions. Whether you need customer service support, technical assistance, or a team of virtual assistants, we have the expertise to help you achieve your business goals.

Company type: Large

Founded: 2018

Company size: 1001 - 5000

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Job description

ISTA Solutions, an outsourcing/offshoring company, is in search of an experienced PHRN Clinical Auditors to join our rapidly expanding team. As a member of our team, you will have the opportunity to work with highly skilled professionals, who prioritize employee satisfaction and work-life balance. At ISTA Solutions, we pride ourselves on creating a culture focused on long-term success and life-long learning. We're looking for a team player who is ready to contribute to our mission, just like you!

Roles and responsibilities:

Review ICD-10 codes to ensure correct clinical category mapping
Identify missed reimbursement opportunities across PT/OT, SLP, NTA, Nursing, and Functional Scoring
Ensure therapy services and clinical documentation are properly aligned
Utilize CMS tools, the RAI Manual, and internal protocols to maintain regulatory compliance
Thoroughly scrub assessments prior to submission for completeness and accuracy

Requirements

Current and valid PHRN license

6 months work experience in a clinical setting
Knowledge with EMR/EHR (Electronic Medical Records/Electronic Healthcare Records)
Knowledge with MDS coding is a PLUS
Strong knowledge of prehospital patient care protocols, standards, and regulatory requirements.
Excellent attention to detail and analytical skills.
Good Verbal and Written English Communication Skills
Ability to work independently and collaboratively in a team-oriented environment.
Commitment to continuous learning and professional development.
Willing to work on shifting schedule.

Benefits

What can we offer you?