Professional Fee Coder/Auditor
What We Strive For
Strive Health is built for purpose — to transform a broken kidney care system. We are fundamentally changing the lives of kidney disease patients through early identification, engagement and comprehensive coordinated care. Strive’s model is driven by a high-touch care team that integrates with local providers and spans the entire care journey from chronic kidney disease through end-stage kidney disease, leveraging comparative and predictive data and analytics to identify at-risk patients. Strive Health’s interventions significantly reduce the rate of emergent dialysis crash, cut inpatient utilization and significantly improve patient outcomes and experience. Come join our journey as we create THE destination for top talent in the healthcare community and set a new standard for how kidney care should be done.
Why We’re Worth the Application
- We Strive for excellence and were recognized as one of America’s Best Startup Employers for 2023 by Forbes, Circle of Excellence, American Society of Transplantation, 2023, Best Places to Work – Denver, Comparably.com, 2022, Best Places to Work – Denver, Built in Colorado, 2022
- We derive innovation and ideas from through authentic diversity intentionally building a team that represents the populations we serve in partnership with our Employee Resource Groups:
- Strive Forward - LGBTQ
- Underrepresented Minorities
- Women and Allies
- We care and support our Strivers within and beyond work to feel fully charged and empowered through our generous wellbeing offerings including:
- Flexible time off
- Companywide wellbeing days
- Volunteer time off
- Leave packages including a sabbatical, parental leave and eight weeks paid for living donor
- Professional development
- A dedicated certified financial planner
- Headspace, Carrot Fertility and Gympass for all Strivers
- We like to have fun by celebrating our successes as a team through team building, company gatherings, trivia, wellbeing raffles, pajama days, a companywide book club and more.
- We value tenacity to help us overcome obstacles with grit and determination to deliver compassionate kidney care.
Professional Fee Coder/Auditor, Revenue Cycle
This position is responsible for Coding and Auditing Professional Fee records to determine the appropriate designation of diagnosis and procedure codes while maintaining compliance with Official Coding Guidelines. The Coding Auditor is responsible for preparing the claim prior to claim submission which includes but is not limited to: validation of patient demographics, insurance and carrier assignment, financial class and other pertinent data fields to ensure the claim is attached to the correct Provider Billing Group classification. During the coding/auditing process, the Profee Coder/Auditor may indicate a provider inquiry or feedback needed and will compose physician-friendly verbiage following prescribed workflow. The ideal candidate in this role will have excellent written and/or verbal communication, analytical skills and demonstrate ability to think critically and operate autonomously in a remote environment.
- Analyze, evaluate, and review medical records to ensure accuracy of code assignment.
- Code professional fee charts and/or validate clinical code assignment (as needed per market).
- Expertise in coding or auditing Renal Specialty of professional fee and be able to code, audit, or train accordingly
- Prepare Physician Inquiries and/or feedback related to code validation audits or other reviews.
- Prepare daily coding logs, independently track production for review, and maintain a coding production rate of 95% or above.
- Demonstrates proficiency in coding including both ICD-10 and CPT while maintaining 95% accuracy or above.
- Conduct claim editing activities, troubleshooting problem accounts, and conducting root cause analysis, following escalation pathway to RCM Leadership as applicable.
- Follow and adhere to AHIMA’s Standards of Ethical Coding, all applicable regulations and guidelines, and all client-specific policies.
- Basic knowledge and experience in Microsoft Office applications (Excel, Office, Word, etc)
- Other duties as assigned
- Associates Degree in Health Information Management with RHIT credential; or active Coding Credential from AHIMA or AAPC coupled with years’ experience.
- 3+ years’ service in a Revenue Cycle Management role with significant experience in physician based (Profee) coding.
- Bachelor of Science in Health Information Management with RHIA Credential
- Expertise in Risk Adjustment Coding
- HCC Certified Coding Credential is a plus
- Experience in a startup, renal care or value-based care environment
- The ideal candidate in this role will have excellent written and/or verbal communication, analytical skills and demonstrate ability to think critically and operate autonomously
- Create Physician-friendly verbiage for provider feedback processes
- Proven ability to be successful in an autonomous work environment
- Skilled in all Microsoft Office Applications
Annual Salary Range: $63,600.00-$74,800.00
Strive Health offers competitive compensation and benefits, including Health insurance, Dental insurance, Vision insurance, 401k Retirement Plan with Employer Match, Life and Accidental Death & Dismemberment insurance, Disability insurance, Health Savings Account, Flexible Spending Account, paid company holidays, in addition to Vacation Time Off. An annual performance bonus, determined by company and individual performance, is available for many roles as aligned to Strive Health guidelines.
Strive Health is an equal opportunity employer and drug free workplace. At this time Strive Health is unable to provide work visa sponsorship. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law. Please apply even if you feel you do not meet all qualifications. If you require reasonable accommodation in completing this application, interviewing, completing any pre-employment testing, or otherwise participating in the employee selection process, please direct your inquiries to email@example.com