Data Validation Administrator

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Job Description:

  • Review patient records to ensure documentation supports appropriate billing and coding; including diagnoses, services rendered, and medical necessity.
  • Identify documentation gaps that may impact reimbursement, compliance, or patient care. Work with providers to resolve them.
  • Assist providers in understanding documentation requirements related to coding Standards (e.g., CPT, ICD-10) and payer guidelines.
  • Conduct routine chart audits to validate accuracy and alignment between clinical documentation and billing data.
  • Collaborate with the billing department to ensure clean claims and reduce denials or rework.
  • Provide real-time or retrospective feedback to clinicians to improve documentation practices
  • Track trends in documentation errors, coding issues, and claim denials. Report findings on leadership.
  • Support compliance with HIPAA, state regulations, and payer-specific requirements.
  • Develop training materials and provide education to medical and clinical staff on best practices for documentation, billing, and coding
  • Assist in the management of organizational projects as needed.
  • Assists in evaluating and standardizing operations, policies, and procedures.
  • Assist with training and education of staff upon request

Requirements:

  • Associate or Bachelor's degree in health information management, Healthcare Administration, Nursing, or related field preferred
  • High School Diploma/GED Required
  • Certified Professional Coder Certification preferred
  • 2+ years of experience in healthcare data validation, clinical documentation improvement (CDI), medical billing/coding, or chart auditing.
  • NextGen software experience preferred.
  • High attention to detail and strong organization skills are essential.
  • Experience using electronic health care records.
  • Excellent interpersonal skills, capable of confidently and effectively presenting and speaking.
  • Able to work independently, collaboratively, and proactively to accomplish work goals.
  • Excellent computer skills.
  • Proficient in basic data analysis, reporting to include spreadsheets, charts, and diagrams.
  • Proficient in Microsoft Office Suite and managing projects through a full cycle process.
  • Must have a Fingerprint clearance card or be eligible to obtain one.

Benefits:

  • Generous PTO
  • 10 paid holidays per year
  • Medical plans (4 choices)
  • Dental plans (2 choices)
  • Vision plans (2 choices)
  • 403(b) retirement plan
  • Retirement Allowance
  • Company paid Life/AD&D and Long-Term Disability
  • Voluntary additional Life and Short-Term Disability
  • Tuition Reimbursement
  • Licensure Reimbursement
  • Elder Care assistance
  • Pet Insurance and much more!
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