Returning Applicant?
Job Code: | 2022-50-R-123 |
Location: | United States – Remote |
Status: | Regular Full Time |
*Regularly performs limited volume of Inpatient coding reviews on medical records to maintain subject matter expertise, and additionally as needed to support business needs.
*Performs audit quality assurance reviews to supplement QA team activity as necessary based upon business need or special projects.
*Contributes to the resolution of quality review rebuttals.
*Performs appeals review/activity to supplement Appeals team based upon business need.
*Actively identifies and recommends opportunities for cost savings and improving outcomes that can have a direct impact to the company’s profitability.
*Effectively contributes to the development of medical review guidelines and training.
*Supports audit management and segment specialists with activities for new concept implementation, maintenance of medical review guidelines for existing concepts.
*Oversee and review audit determinations in order to ensure consistency in decision-making.
*Collaborate with other departments to resolve operational problems.
*Proactively monitors and in alignment with applicable management ensures activity required to meet team staffing levels necessary for assigned business segment objectives.
*Provides support as needed to ensure auditors are equipped with tools and resources required to perform audits.
*Supervise daily activities of coding audit staff members.
*Provide audit guidance to medical review staff; identify trends and present solutions.
*Routinely provides production and quality performance-based progress reports, coaching, and constructive feedback to staff.
*Manages team Time and Attendance (time off/use of accruals, attendance, attendance points and timecards for hourly staff, etc.) in accordance with applicable policies and procedures.
*Collaborates with HR for applicable corrective action as applicable.
*Complete and conduct performance reviews for assigned staff.
*Conduct team meetings with direct reports on a regular basis.
*Provide leadership to team members, provide solutions, and resolve conflicts.
* Escalate to management and collaborate with HR as applicable to bring appropriate solutions to employee matters.
* Provide reporting and updates to management as required and appropriate for operational and staff activity and results.
*Participates in and contributes to applicable department meetings.
*May participate to client-facing meetings; research and analyze issues; present findings and solutions; and/or provider training.
*May support management with activities to monitor inventory and activity of 3rdparty/subcontractors.
*Become subject matter expert for assigned business segment(s).
*Maintain current knowledge and changes that affect our industry and clients as it pertains to medical practice, technology, regulations, legislation, and business trends.
*May support training material/tools and best practices development.
*Identify needs and ensure team receives necessary training.
*Support training activities for new audit staff or provide supplemental training for existing staff as needed.
*Notes:
All employees and contractors for Performant Financial may and/or will have access to Sensitive, Proprietary, Confidential and/or Public data. As such, all employees and contractors will have ownership and responsibility to report any violations to the Confidentiality and Integrity of Sensitive, Proprietary, Confidential and/or Public data at all times. Violations to Performant’s policy related to the Confidentiality or Integrity of data may be subject to disciplinary actions up to and including termination.
*Completion of Teleworker Agreement upon hire, and adherence to the Agreement (and related policies and procedures) including, but not limited to: able to navigate computer and phone systems as a user to work remote independently using on-line resources, must have high-speed internet connectivity, appropriate workspace able to be compliant with HIPAA, safety & ergonomics, confidentiality, and dedicated work focus without distractions during work hours.
Physical Requirements:
**NOTE: Must be able to meet requirements for and perform work assignments in accordance with Company policies and expectations on a home remote basis (and must meet Performant remote-worker requirements) until at which time staff will be notified and required to work from a Performant office location. Basic office equipment required to perform remote work is provided by the company.
*Performs duties in a busy standard office environment with moderate noise level. (or home-based Telework environment in accordance with Company policies and procedures).
*Sits or stands at a desk, reaching as needed to use office equipment.
*Makes and returns calls using an office phone system or company issued cellular phone.
*Views a computer monitor, types on a keyboard, and uses a mouse.
*Reads and comprehends information in electronic (computer) or paper form (written/printed).
*Types frequently, but not constantly, using a keyboard and mouse.
*Occasionally lifts/carries/pushes/pulls up to 10 pounds.
*Travel as required to meet business needs.
Other Requirements
*Must submit to and pass pre-hire background check, as well as additional checks throughout employment
*Must be able to pass a criminal background check; must not have any felony convictions or specific misdemeanors, nor on state/federal debarment or exclusion lists.
*Must submit to and pass drug screen pre-employment (and throughout employment).
*Performant is a government contractor. Certain client assignments for this position requires submission to and successful outcome of additional background and/or clearances throughout employment with the Company.
Visa sponsorship is not available.
Job Profile is subject to change at any time.
EEO
Performant Financial Corporation is an Equal Opportunity Employer.
Performant Financial Corporation is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, age, religion, gender, gender identity, sexual orientation, pregnancy, age, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law.
NO AGENCY SUBMISSIONS WITHOUT PERFORMANT AUTHORIZED AGENCY AGREEMENT AND APPROVED PERFORMANT JOB ORDER
Performant Corporation is an Equal Opportunity Employer.
Performant Financial Corporation is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, age, religion, gender, gender identity, sexual orientation, pregnancy, age, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law.
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