Audit Specialist

Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world’s health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem – including providers, health plans, researchers, and life sciences companies. From fulfilling a single patient’s request for their medical records to powering the AI revolution in healthcare, Datavants are building the future of how data is connected and used to improve health. By joining Datavant today, you’re stepping onto a driven and highly collaborative team that is passionate about creating transformative change in healthcare. Inpatient Auditing Specialist You will be instrumental in addressing consulting and educational needs related to coding quality, compliance assessments, external payer reviews, coding education, interim coding management, and coding workflow operations reviews. This fully‑remote role offers a flexible schedule, allowing you to help shape the future of healthcare from your own workspace! *Seeking a full‑time Inpatient Audit Specialist with 3+ years’ experience. Experience with Streamline evaluator, Cerner, 3M a plus. Will be responsible for onboarding and monthly IP coding QA.* You Will: Conduct inpatient coding audits on medical records, utilizing ICD‑10‑CM, CPT, and appropriate coding references for accurate DRG and APC assignment. Review non‑CC/MCC records to assess proper coding or identify the need for additional documentation. Scrutinize all HCPCS and CPT codes influencing APC assignment. Provide coder education through the auditing process. Prepare preliminary results for review by the facility or CCS HIM director. Review disagreements on APC/DRG changes with the appropriate manager. Prepare the final reports for the coding audit and actively participate in the resolution of audit findings. Provide coder education via email and/or conference calls, utilizing the audit spreadsheet findings and comments. Attend coding workshops as necessary. Stay current with regulatory changes. Organize and prioritize multiple cases concurrently to ensure departmental workflow and prompt case resolution. Demonstrate versatility and exceptional work across a wide range of coded services. Meet with client facility representatives to discuss issues and trends identified in audits. Develop and implement education for physicians, nursing, and other clinical staff to enhance documentation. Communicate effectively with co‑workers, management, and hospital staff regarding clinical and reimbursement issues. Function in a professional, efficient, and positive manner. Adhere to the American Health Information Management Association’s code of ethics. Maintain a customer‑service focus and exhibit professionalism, flexibility, dependability, a desire to learn, and commitment to excellence. Conduct audits on external coding staff as needed and provide reports to the manager as directed. Handle a high complexity of work functions and decision‑making. Demonstrate strong organizational, teamwork, and leadership skills. What you will bring to the table: 3+ years experience coding and auditing Associate or Bachelor’s degree from an AHIMA‑certified HIM or Nursing Program, or completion of a certificate program from AAPC with a preference for CCS Preferred: CCS, RHIT, or RHIA credentials. Recent experience in academic/level 1 trauma centers Experience coding and auditing inpatient and outpatient records for various facilities Track record of acceptable productivity standards Maintain 95% accuracy rate for APC assignment and 95% productivity rate Experience with various software including EMR, Encoder and Auditing software Perks: Benefits for Full‑Time employees: Medical, Dental, Vision, 401k Savings Plan with match, 2 weeks of paid time off, and Paid Holidays. Free CEUs every year Stipend provided to assist with education and professional dues (AHIMA/AAPC) if applicable Equipment: monitor, laptop, mouse, headset, and keyboard Comprehensive training led by a credentialed professional coding manager Exceptional service‑style management and mentorship (we’re in this together!) Our compensation philosophy is to be externally competitive, internally fair, and not win or lose on compensation. Salary ranges for this position are developed with the support of benchmarks (competitive San Francisco rates for US‑based roles) and industry best practices. The estimated base pay range per hour for this role is: $35—$45 USD. To ensure the safety of patients and staff, many of our clients require post‑offer health screenings and proof and/or completion of various vaccinations such as the flu shot, Tdap, COVID‑19, etc. Exemptions may be available on the basis of disability, medical contraindications to the vaccine or any of its components, pregnancy or pregnancy‑related medical conditions, and/or religion. This job is not eligible for employment sponsorship. Datavant is a proud Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, or other legally protected status. We are committed to a work environment free from discrimination. #J-18808-Ljbffr