Inpatient Coding Auditor, Senior Associate- Remote (Any city, TX, US, 99999)

It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development. Summary We are seeking a talented individual for an Inpatient Coding Auditor, Senior Associate who is responsible for performing coding reviews of inpatient medical records and/or other documentation to determine correct coding, as defined by review methodologies specific to the contract for which review services are being provided. This involves accessing proprietary systems to audit medical records, accurately document findings, and provide policy/regulatory support for determinations. The candidate must have an extensive background in either facility-based inpatient coding and/or outpatient coding edits and a high level of understanding of reimbursement guidelines, specifically the MS-DRG, AP-DRG, APR-DRG, ASC, and APC payment systems. Your role in our mission Performs audits of inpatient medical record documentation to determine the accuracy of principal and secondary diagnosis (including MCCs and CCs) and procedure codes. Validates the assignment and sequencing of ICD-10 codes, discharge status, Hospital-Acquired Conditions, POA assignment, and DRG assignment. Adheres to official coding guidelines, Coding Clinic guidance, and regulatory mandates. Draws on advanced ICD-10 coding expertise to substantiate conclusions. Utilizes proprietary auditing systems with a high level of proficiency to document audit determinations and rationale. Consistently achieves productivity and quality performance standards established