Inpatient Audit Specialist FT

Accountabilities

• Conduct detailed coding audits using ICD-10-CM, CPT, and relevant coding guidelines to validate DRG and APC assignments.
• Review medical records to assess coding accuracy, documentation completeness, and compliance with regulatory standards.
• Analyze non-CC/MCC records and identify opportunities for additional documentation improvement.
• Provide coding education and feedback to coding teams, clinical staff, and healthcare stakeholders based on audit findings.
• Prepare audit reports, communicate results, and support resolution of identified issues.
• Review and resolve disagreements related to DRG and APC changes with appropriate leadership teams.
• Maintain strong organizational skills while managing multiple complex cases and meeting quality and productivity expectations.
• Collaborate with facility representatives to discuss audit trends, opportunities, and improvement strategies.
• Support external coding audits and provide recommendations to improve coding quality and productivity.
• Maintain current knowledge of healthcare coding standards and industry requirements.

Requirements

• Strong inpatient coding and auditing expertise, excellent analytical abilities, and experience working within healthcare information management environments.
• Comfortable interpreting complex medical records, communicating findings clearly, and supporting teams through education and process improvement.
• 3+ years of experience in medical coding and auditing, with a focus on inpatient records.
• Associate or Bachelor’s degree from an AHIMA-certified Health Information Management or Nursing program, or completion of an accredited coding certification program.
• PREFERRED: CCS, RHIT, or RHIA credentials.
• Strong knowledge of ICD-10-CM, CPT, DRG, and APC assignment methodologies.
• Experience auditing inpatient and outpatient records across different healthcare facilities.
• Experience working with EMR systems, encoder tools, and auditing software.
• Familiarity with platforms such as Cerner PowerChart and 3M360 is preferred.
• Experience supporting academic medical centers or Level 1 trauma facilities is highly valued.
• Ability to maintain strong accuracy and productivity standards, including 95% accuracy for APC assignments and productivity targets.
• Excellent analytical, problem-solving, communication, and organizational skills.
• Strong commitment to professionalism, confidentiality, customer service, and healthcare coding ethics.
• Ability to work independently while collaborating effectively with remote teams.

Benefits

• Estimated compensation range of $35-$45 USD per hour.
• $2,500 sign-on bonus.
• Fully remote work environment with flexible scheduling options.
• Medical, dental, and vision insurance coverage.
• 401(k) savings plan with company matching.
• Paid time off, paid holidays, and floating holidays.
• Free continuing education units (CEUs) each year.
• Education and professional membership support for AHIMA/AAPC dues when applicable.
• Company-provided equipment, including laptop, monitor, keyboard, mouse, and headset.
• Comprehensive training led by experienced coding professionals.
• Supportive management, mentorship, and opportunities for professional development.