Title: Coding Auditor Hospital Inpatient Location: Home United States Scheduled Weekly Hours : 40 Shift : Day Schedule : Regular Full time Work From Home : Yes Job Description: Work From Home Work From Home Work From Home, Indiana 46544 The Inpatient Hospital Coding Auditor conducts coding audits specific to ICD10CM and PCS; As well as validating the accuracy of the MS DRG or APR DRG assignment to ensure compliance with reimbursement methodologies, quality standards, and official coding guidelines. WHO WE ARE With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care for our patients and the communities we serve. WHAT YOU CAN EXPECT - Review, research, and respond to coding inquiries from other Franciscan departments. - Integrate current industry changes into a clinical audit practice setting. - Act as a subject matter expert regarding payer reimbursement methodologies and official coding guidelines. - Assist Coding Supervisor with reviewing and responding to external coding audits. - Perform quality reviews to ensure compliance with payer reimbursement methodologies and official coding guidelines. - Provide audit results and trends to the Coding Education Specialists for education development and training. - Summarize quality review results for Coding Managers, Supervisors, Coding Education Specialists, and coding staff. QUALIFICATIONS - Associate's Degree, Health Information Management or related field - Required - High School Diploma/GED With 5 years of Franciscan coding experience in lieu of degree - Required - 5 years Coding Experience relevant to auditing specialty with RHIT/RHIA - Required - 5 years Franciscan coding experience relevant to the auditing specialty with CCS - Required - 2 years Coding Support role with RHIT/RHIA - Preferred - Certified Coding Specialist (CCS) - American Health Information Management Association (AHIMA) - Required - Registered Health Information Technician (RHIT) - American Health Information Management Association (AHIMA) - Preferred - Registered Health Information Administrator (RHIA) - American Health Information Management Association (AHIMA) - Preferred - Ability to work collaboratively within a team environment and provide support coverage or assistance when needed - Required TRAVEL IS REQUIRED: Never or Rarely JOB RANGE: Coding Auditor - Hospital Inpatient $51001.60-$75868.00

Role Description The Diagnostic Related Groups (DRG) Clinical Auditor will be responsible for performing DRG validation (clinical/coding) reviews of medical records and/or other documentation. This role will determine correct DRG/coding as defined by review methodologies specific to the type of review. This involves completing medical record reviews, accurately documenting findings and non-findings and providing clinical/policy/regulatory support for the determination. This role will utilize their experience with ICD-10-CM & PCS coding guidelines, the ability to understand modern pharmacology, disease management and clinical intervention procedures. The ideal DRG Clinical Auditor candidate has strong written and verbal communication skills, clinical knowledge of disease processes, and knowledge of medical necessity rules. - The Clinical Auditor will review medical records to determine accuracy of billing through verification of coding and review of supporting clinical documentation. - Conduct audits to ensure accurate reimbursement and identifying potential savings. - Demonstrated knowledge of ICD-10-CM codes, PCS and DRG coding, understanding of payer rules and regulations, including Medicare and Medicaid. - Understand and comply with all internal and external policies. - Working knowledge of HIPAA Privacy and Security Rules. - Assist Quality Control team and medical director with appeals, rebuttals, etc. - Notify leadership of any issues or concerns in a timely manner. - Additional duties as assigned. Qualifications - Proficient understanding of Medicare, CMS guidelines and ICD-10 coding guidelines. - Effective and professional communication skills, both verbal and written. - Ability to work independently and in a team environment. - High attention to detail. - Must possess critical thinking skills. - Ability to multi-task and assist with team coverage and provide support when needed. - Ability to build relationships both internally and externally. - Ability to work in a fast-paced environment. - Demonstrated proficiency in basic computer skills and typing. - Proficiency with Microsoft Office. Requirements - LVN or RN license in the state of employment preferred. - CCS or CIC required with DRG auditing experience in ICD-10-CM, ICD-10 PCS. - Experience in the OR, ICU, or ER as an RN highly preferred. Pay Range CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process. Pay Range: $70,143 – $107,253 Benefits A comprehensive benefits package is available for full-time regular employees and includes: - Medical (HDHP) w/Pharmacy - Dental - Vision - Long Term Disability - Health Savings Account - Flexible Spending Account Options - Life Insurance - Accident Insurance - Critical Illness Insurance - Pre-paid Legal Insurance - Parking and Transit FSA accounts - 401K - ROTH 401K - Paid time off Company Description CERIS, a division of CorVel Corporation, a certified Great Place to Work® Company, offers incremental value, experience, and a sincere dedication to our valued partners. Through our clinical expertise and cost containment solutions, we are committed to accuracy and transparency in healthcare payments. We are a stable and growing company with a strong, supportive culture along with plenty of career advancement opportunities. We embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!). CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.

• Apoya en ejecutar y analizar pruebas selectivas de trabajo dentro de las sucursales para minimizar los diversos riesgos que se puedan presentar la situación financiera de la empresa. • Este puesto será responsable de identificar y analizar los riesgos actuales, así como reducir las probabilidades de ocurrencia; esto conlleva la realización de diversas evaluaciones, incluidos inventarios físicos completos y evaluaciones de cumplimiento, tal y como exige las políticas, procedimientos y normativos. • Preparar con calidad y puntualidad los informes de inventario y cumplimiento, así como preparar informes que describen los hallazgos, explicar riesgos y recomiendan cambios. • Revisar los datos financieros y la información relativa a las operaciones de la sucursal a revisar. • Identificar y analizar áreas de riesgo potencial para los activos de la sucursal. • Realizar análisis estadísticos y presenciales para identificar y categorizar el riesgo. • Ayudar a desarrollar estrategias de mitigación de riesgos e implementarlas. • Analizar los recientes cambios en la empresa, con el fin de actualizar los informes. • Toma física de inventarios de mercancía y revisión del correcto funcionamiento de la mercancía. • Revisar inventario de joyería y calado de oro. • Conciliar existencias del inventario sistema vs físico. • Recabar información para aclarar diferencias. • Detectar mercancía dañada o sobreevaluada. • Arqueo de valores en bóveda y cajas de mostrador. • Revisar los procesos relacionados a las sucursales, empeño, almacén. • Comentar Actas de Revisiones con DMs de las tiendas donde la calificación sea Aprobatoria. • Registrar las actas de revisiones se hayan subido a los respaldos digitales (teams, plataforma CRS). • Detectar posible Oro Fake que se tenga en las tiendas. • Realizar cambios de estatus en sistema POS2. • Atender los casos Robos, asaltos e intrusiones registrados en las sucursales. • Cubrir guardias fines de semana para atención de urgencias de casos que surjan en las tiendas. • Registrar puntualmente los gastos de viaje en Workday. • Realizar inventarios en las tiendas de nueva apertura. • Ejecutar el checklist multimateria de Legal-Cumplimiento. • Analizar información de plataforma BI Inventory Analysis / In-Transit. • Validar y analizar las alertas generadas en la plataforma DATADOG – del programa EZ+. • Apoyar en la gestión de cálculo de millaje y combustible de las rutas establecidas por el Auditor Lead.

Role Description Als Shop Auditor stellst du sicher, dass die Markenstandards unserer Kunden perfekt umgesetzt werden. Du prüfst Verkaufsstellen auf Herz und Nieren – von der Warenpräsentation bis hin zu aktuellen Promotionen. Dabei agierst du nicht nur als Prüfer:in, sondern als kompetente:r Ansprechpartner:in für das Filialpersonal. - Qualitäts-Checks: Du besuchst Verkaufsstellen und prüfst objektiv definierte Kriterien wie Sauberkeit, Warenverfügbarkeit und die korrekte Umsetzung von Promotionen. - Warenpräsentation: Du kontrollierst, ob das Visual Merchandising den internen Vorgaben unserer Kunden entspricht. - Direktes Feedback-Gespräch: Nach dem Audit trittst du als Fachperson gegenüber der Mitarbeiter in der Verkaufsstelle auf. Du besprichst die Ergebnisse sachlich, gibst konstruktive Optimierungsvorschläge und hältst Best Practices fest. - Reporting: Deine Ergebnisse und Fotos hältst du präzise in unserem digitalen Reporting-Tool via Smartphone fest. Qualifications - Auge fürs Detail: Dir entgeht keine falsch platzierte Ware und kein fehlendes Preisschild. - Kommunikationsstärke: Du kannst Feedback so vermitteln, dass es als Unterstützung und nicht als Kritik wahrgenommen wird. Ein sicheres, professionelles Auftreten ist für dich selbstverständlich. - Selbstorganisation: Du planst deine Touren eigenständig und effizient. - Mobilität & Technik: Du besitzt ein eigenes Auto, ein Smartphone für die Dokumentation sowie ein Laptop für die Planung. Excel ist kein Fremdwort für dich. - Leumund: Ein einwandfreier Leumund ist Voraussetzung für diese Vertrauensposition. Benefits - Spannende Einblicke: Lerne die Strategien und internen Standards bekannter Marken und Detailhändler kennen. - Maximale Flexibilität: Du teilst dir deine Einsätze (ca. 10–20 Std./Monat) völlig frei ein – ideal als Ergänzung zum Studium oder Hauptberuf. - Verantwortung: Eine abwechslungsreiche Tätigkeit, bei der deine Analyse direkte Auswirkungen auf die Shop-Qualität hat. - Attraktive Konditionen: Faire Vergütung inklusive Kilometerentschädigung. - Einarbeitung: Wir bereiten dich gründlich auf deine Einsätze vor.