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Risk Adjustment Auditor

Fathom

Fathom

United States · Remote
Posted on Thursday, February 15, 2024

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.

Fathom is looking for an experienced Risk Adjustment Auditor to join the team. As an auditor, you will support the risk adjustment QA and audit functions, as well as provide education and training to the Fathom engineering and product teams. Fathom will also provide a budget for ongoing medical coding education and certification.

Please note that this position 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
  • Performing audits to determine coding accuracy
  • Preparing reports as requested by the operations team
  • Providing coding insights, education, and examples to Fathom engineers and product team and staff to accelerate product development
  • Tracking, aggregating and summarizing the changing coding and billing rules for the product team

We are looking for a teammate with:

  • Current AAPC CRC certification or AHIMA RAC microcredential
  • 3+ years of experience auditing risk adjustment coding
  • Knowledge of anatomy/physiology and disease process and medical terminology
  • A deep understanding of coding guidelines, documentation requirements as well as familiarity with medications and reimbursement guidelines

Bonus points if you have:

  • Prior encoder experience
  • Additional AHIMA or AAPC certifications
  • Conducted medical coding training
  • Experience with clinical documentation improvement
  • Experience in an entrepreneurial environment

Salary range:

  • $70 000 - $100 000 USD