Inpatient Coding Auditor

Job Title: Inpatient Coding Auditor II

Location: Fully remote - Limited to candidates in OK, KS, MO, TX, and AR

Duration: 13 weeks

Shift/Schedule: Monday–Friday; 40 hours/week, 8 hours/day.

Job Summary:

Inpatient Coding Auditor II position responsible for inpatient coding quality reviews, auditing, DRG validation, query compliance, coding staff support, training, mentoring, and maintaining coding accuracy and productivity standards.

Job Responsibilities:

• Perform peer-to-peer auditor reviews and audit auditor quality reviews.
• Review query compliance and quality, and provide feedback as appropriate.
• Respond to coding-related questions from internal and external coding staff.
• Initiate the rebilling process as required by policy for special projects.
• Identify and share data-driven workflow adaptations to reduce errors and improve coding efficiency.
• Assist in developing tip sheets and training materials for coding and auditing staff based on:
• Analysis of coder error trend data.
• Annual code set and guideline updates, and quarterly coding clinics.
• Updated workflows and facility-specific policies.
• Meet all educational requirements as outlined in current Company policy.
• Perform coding quality reviews for inpatient coding across client, including routine monthly reviews, focus pre-bill reviews, CDI reconciliations, and second-level review work queues.
• Assist with onboarding new employees by providing workflow and process training, assessing pre-production work, delivering feedback, and mentoring employees through their transition to full production.
• Communicate directly with other teams and departments to resolve issues related to account reviews and code/DRG validation.
• Maintain or exceed established productivity and accuracy standards to support team performance, data integrity, and organizational objectives.
• Coach and mentor coding staff in developing and enhancing their skills.
• Review official data quality standards, coding guidelines, Company policies and procedures, and clinical/medical resources to ensure coding knowledge and skills remain current.
• Perform other duties as assigned.

Education:

• High School diploma or GED.

Licensure & Certifications:

• RHIA, RHIT, CCS, CPC, or CIC.

Required Skills & Experience:

• At least 4 years of Hospital/facility Inpatient Coding experience including Principal Diagnosis selection, DRG Assignment, Secondary diagnosis coding, Procedure coding using ICD 10-PCS.
• Experience coding Inpatient Accounts with DRG assignment from Neurosurgery, Cardiothoracic, Orthopedic, and General/Oncology Surgery
• Experience with querying physicians for clarification
• At least 1 year of Inpatient Hospital-based coding Auditing/DRG Validation experience including Validation of principal diagnosis and principal procedure, Accuracy/quality check review of diagnostic and PCS procedure codes, Validation of account abstraction
• Extensive IP Coding acute care and trauma coding experience.
• Academic Medical Center and Trauma Center experience preferred.
• Pre-employment IP Coding and Auditing assessments required before interview.
• Outpatient Facility and Professional Coding for Inpatient Admissions is not an acceptable substitute for IP experience.
• EPIC is used with Solventum/3M 360 and MS-DRGs and APR-DRGs.
• Contingent employee must have sufficient, stable internet access for use of multiple applications.