Risk Adjustment Auditor

Posted 10 Days Ago
Hiring Remotely in USA
Remote
Mid level
Marketing Tech • Social Media • Analytics
The Role
The Risk Adjustment Auditor will review medical records for correct diagnosis code assignment, perform audits to assess coding accuracy, prepare reports, provide coding education to the engineering and product teams, and summarize changes in coding and billing rules.
Summary Generated by Built In

Fathom is on a mission to use AI to understand and structure the world’s medical data, starting by making sense of the terabytes of clinician notes contained within the electronic health records of the world’s largest health systems. Our deep learning engine automates the translation of patient records into the billing codes used for healthcare provider reimbursement, a process today that costs hospitals in the US $15B+ annually and tens of billions more in errors and denied claims. We are a venture-backed company that completed a Series B round of financing for $46M in late 2022.

We are seeking a Risk Adjustment Auditor to contribute to Fathom’s next stage of growth. This role is a unique opportunity for an experienced medical coder with robust risk adjustment auditing experience, excellent communication and self-presentation skills, the drive to help a high-growth startup scale, and the desire to transform the future of medical coding.  If this speaks to you, we want to hear from you!

Please note that this position is full-time and requires physical residency in the U.S.


Your role and responsibilities will include:

  • Reviewing medical records to ensure the correct diagnosis codes were assigned for risk adjustment coding
  • Reviewing and auditing medical records and physician documentation for HCC accuracy
  • Preparing audit results reports as requested by the engineering and client success teams
  • Providing coding insights, education, and examples to Fathom engineering and client success teams to accelerate product development
  • Tracking, aggregating and summarizing the changing coding and billing rules for the engineering and client success teams


We are looking for a teammate with:

  • A current AAPC CRC certification or AHIMA RAC microcredential
  • 3+ years recently auditing risk adjustment coding
  • Knowledge of anatomy/physiology and disease process and medical terminology
  • Deep understanding of current coding guidelines, reimbursement guidelines, medications, and documentation requirements
  • Strong knowledge of anatomy/physiology, diseases, and medical terminology
  • Strong verbal and written communication skills
  • Enthusiasm for technological innovation in medical coding


Bonus points if you have:

  • Experience with clinical documentation improvement and education
  • Experience with fee-for-service procedure and diagnosis coding
  • Experience building and implementing audit plans
  • Experience working with external clients
  • Experience in an entrepreneurial/startup environment
  • Prior encoder experience


Compensation:

  • Salary: $70,000 USD - $100,000 USD
  • Company Equity


Benefits:

  • PTO and Uncapped Sick Days
  • Medical/Dental/Vision Coverage
  • 401k Matching
  • $1,500 USD Home Office Budget
  • Support for ongoing medical coding education and certification
  • Virtual and Local Office (San Francisco, New York City  and Toronto) Team Building Events
  • Annual Company Off-site


The Company
HQ: Cleveland, OH
101 Employees
On-site Workplace
Year Founded: 1997

What We Do

Fathom is an Award-Winning Digital Marketing Agency that works with transformational marketers looking to punch above their weight.

We're Fathom. We're digital marketers who believe strong strategy starts with deep roots--in our clients'​ business, in digital, and in outcomes. We partner with CMOs and senior marketing leaders across education, B2B services, technology and SaaS, healthcare and wellness, financial services and manufacturing verticals. It's about you, it's about us, it's about what we'll do together.

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