Inpatient Coding Auditor, Senior Associate- Remote

About the Role

We are seeking a talented individual for a senior-level Inpatient Coding Auditor position. This role involves performing coding reviews of inpatient medical records and other documentation to determine correct coding, as defined by review methodologies specific to the contract. Responsibilities include accessing proprietary systems to audit medical records, accurately documenting findings, and providing policy/regulatory support for determinations.

You will leverage an extensive background in facility-based inpatient coding and/or outpatient coding edits, along with a high-level understanding of reimbursement guidelines, including MS-DRG, AP-DRG, APR-DRG, ASC, and APC payment systems.

Responsibilities

• Perform audits of inpatient medical record documentation to determine the accuracy of principal and secondary diagnosis (including MCCs and CCs) and procedure codes.
• Validate the assignment and sequencing of ICD-10 codes, discharge status, Hospital-Acquired Conditions, POA assignment, and DRG assignment.
• Adhere to official coding guidelines, Coding Clinic guidance, and regulatory mandates.
• Utilize advanced ICD-10 coding expertise to substantiate audit conclusions.
• Use proprietary auditing systems with proficiency to document audit determinations and rationale.
• Consistently meet productivity and quality performance standards established by management.
• Cross-train to perform reviews of multiple claim types to provide a flexible workforce that meets client needs.
• Assist management with training new Coding Auditors, including daily monitoring, mentoring, feedback, and education.
• Maintain current knowledge of coding guidelines and complete required CEUs to maintain coding certification.
• Attend training sessions and scheduled meetings to enhance skills and working knowledge of clinical policies, procedures, rules, and regulations.

Requirements

• One or more active professional credentials through AHIMA or AAPC (CPC, CCS, COC, RHIA, RHIT); required.
• 2+ years of experience in inpatient medical record coding and/or auditing; required.
• Demonstrated proficiency in medical record auditing and ICD-10-CM, ICD-10-PCS, APC, ASC, HCPCS, and CPT coding methodologies.
• Thorough understanding of APR-DRG, AP-DRG, and MS-DRG.
• Proficiency in computer skills, including Microsoft Windows, Outlook, Excel, Word, PowerPoint, internet browsers, and virtual meeting tools such as Microsoft Teams and Zoom.

Benefits

• Benefits begin on the first day of employment.
• Clear path for advancement with training and leadership opportunities.
• Generous, flexible vacation policy for salaried, full-time employees.
• 401(k) employer match.
• Comprehensive health benefits.
• Educational assistance.
• Leadership and technical development academies to build skills and capabilities.

Pay

The pay range for this position is $70,000.00 - $80,000.00 per year. The base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors.

Schedule

• Remote position within the U.S.
• 0-10% travel.