Inpatient Coding Auditor

This is a Full Remote job, available from anywhere.

Role Summary:

Responsible for reviewing inpatient coding to validate accuracy, compliance, and documentation support. This role identifies risks, ensures consistency in DRG assignment, and provides actionable feedback to improve coding quality.

Core Responsibilities:

• Perform retrospective and/or concurrent audits of inpatient coding.
• Validate ICD-10-CM/PCS code assignment and MS-DRG/APR-DRG accuracy.
• Follow and adhere to AHIMA’s Standards of Ethical Coding, all applicable regulations and guidelines, and all client specific policies.
• Identify trends, risks, and opportunities for coding improvement.
• Provide clear, actionable audit feedback and education to client & internal coding staff.
• Maintain established quality metrics (e.g., 95% coding accuracy) and meet productivity standards.

• Minimum Qualifications:
• Credentials: CCS, RHIA, or RHIT (active).
• Experience: Minimum 3+ years of inpatient coding and at least 2 years of auditing experience. In lieu of auditing experience, 7+ years of coding experience is required.
• Skills & Knowledge: Strong knowledge of ICD-10-CM/PCS, MS-DRG/APR-DRG assignment, and Coding Clinic guidance. Strong analytical and written communication skills.
• Client & Specialty Alignments:
• Specialty Expectations: Strong understanding of methodologies to validate documentation impacting severity, risk, and reimbursement.