Inpatient Auditor

About the role

We are seeking a highly skilled coding professional to audit complex inpatient and outpatient medical records, ensure coding accuracy and compliance, and serve as a subject matter expert for coding teams.

Responsibilities

• Audit & Compliance
  • Audit inpatient, ambulatory surgery, observation, and outpatient encounters to ensure accurate reimbursement and compliance with federal and state regulations.
  • Review and validate ICD-10-CM, ICD-10-PCS, and CPT-4 coding assignments.
  • Audit complex inpatient cases including trauma, neurology, rehabilitation, critical care, and other high-acuity services.
  • Ensure accurate APR-DRG, SOI/ROM, and POA assignments.
  • Analyze clinical documentation and identify coding opportunities or discrepancies.
• Coding Quality & Education
  • Serve as a coding subject matter expert and resource for Coding Specialists.
  • Conduct focused audits and quality reviews as needed.
  • Maintain coding accuracy and productivity metrics.
  • Provide coaching, education, and training to coding staff and new hires.
  • Research new procedures, surgical techniques, and emerging healthcare technologies.
• Collaboration & Communication
  • Partner with Clinical Documentation Integrity (CDI) teams and providers to improve documentation quality.
  • Assist coding specialists with creating appropriate coding queries.
  • Collaborate with hospital departments regarding coding accuracy and compliance concerns.
  • Understand and apply concepts related to Potentially Preventable Complications (PPCs), Maryland Hospital Acquired Conditions (MHACs), Prevention Quality Indicators (PQIs), and related quality measures.
• Compliance Standards
  • Maintain adherence to AHIMA ethical coding standards and coding compliance guidelines.
  • Stay current on coding regulations, payer requirements, and industry updates.

Qualifications

• Education: High School Diploma or GED required. Formal training in ICD-10-CM, ICD-10-PCS, and CPT-4 coding. Associate's or Bachelor's degree preferred (education may be considered in lieu of some experience).
• Experience: Minimum of 2 years of ICD-10-CM/ICD-10-PCS coding and abstracting experience within a Level I Trauma Hospital, OR 4 years of inpatient hospital coding experience. 2–3 years of ambulatory/outpatient coding experience. Experience auditing complex inpatient cases preferred.
• Certifications: One Required: Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), or Certified Inpatient Coder (CIC).

Benefits

Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: Medical, dental & vision, Critical Illness, Accident, and Hospital, 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available, Life Insurance (Voluntary Life & AD&D for the employee and dependents), Short and long-term disability, Health Spending Account (HSA), Transportation benefits, Employee Assistance Program, Time Off/Leave (PTO, Vacation or Sick Leave).

Pay

The pay range for this position is $36.00 - $40.00/hr.