Inpatient Coding Auditor WFH

About the role

This position may be filled as levels I, II, or III, depending on individual experience, education, certification(s), and business need. Ideal candidate will have experience in complex inpatient coding at an academic medical center.

General Description

Ensures accurate, quality, and compliant Inpatient facility coding through prebill and retrospective audits of coder work and providing targeted education to improve consistency and documentation quality.

Essential Job Duties

• Performs all functions of coding quality reviews (routine monthly, focus pre-bill, CDI Reconciliations, second-level review work queues) for inpatient coding across OUH.
• Performs peer-to-peer auditor reviews.
• Communicate with other teams and departments directly as needed to resolve immediate issues related to account reviews and code/DRG validation.
• Responds to coding-related questions from internal and external coding staff.
• Initiates the rebilling process as required per policy on special projects.
• Trials tip sheets and training developed by auditing team and provide constructive feedback.
• Maintains or exceeds established productivity and accuracy standards, delivering consistent day‑to‑day results that directly support team performance, data integrity, and organizational objectives.
• Meets all educational requirements as stated in current Company policy.
• Reviews all official data quality standards, coding guidelines, Company policies and procedures, and clinical/medical resources to assure coding knowledge and skills remain current.
• Performs other duties as assigned.

Minimum Requirements (Level 1)

• Education: High School diploma or GED required.
• Experience: At least 1 year of Inpatient Facility Coding Auditing or DRG Validation with a minimum of 5 years of experience in Inpatient facility coding required.
• Certification/License/Registration: RHIA, RHIT, CCS, CPC, or CIC required.

Minimum Requirements (Level 2)

• Education: High School diploma or GED required.
• Experience: At least 3 years of experience in Inpatient Facility Coding Auditing or DRG Validation, including at least 2 years of coding at an Academic Health Center required.
• Certification/License/Registration: RHIA, RHIT, CCS, CPC, or CIC required.

Minimum Requirements (Level 3)

• Education: Associate's degree required.
• Experience: At least 5 years of experience Inpatient Facility Coding Auditing at an Academic Health Center required.
• Certification/License/Registration: RHIA, RHIT, CCS, CPC, or CIC required. HFMA CRCR required within 6 months of hire.