Job Summary
We are seeking an experienced Inpatient Coding Quality Auditor / Coding Educator to perform quality reviews of inpatient coding, ensure compliance with national coding guidelines, and provide education to improve coding accuracy and documentation quality. This role partners closely with Coding Leadership to identify root causes of coding errors, support DRG validation, and develop training programs to maintain high standards of coding integrity and reimbursement accuracy.
Key Responsibilities
Coding Quality & Auditing
- Perform routine, pre-bill, and targeted quality reviews for inpatient and outpatient facility coding
- Validate DRGs, ICD-10-CM / PCS codes, POA indicators, and documentation support
- Initiate rebilling processes when errors are identified per policy
- Research complex coding issues and escalate as needed
Required Qualifications
Education
High School Diploma or GED requiredAssociate's or Bachelor's degree in HIM / HIT preferredExperience
5+ years inpatient acute care facility coding experience3+ years coding auditing, DRG validation, or coding education experienceStrong experience with ICD-10-PCS and trauma codingOutpatient or professional coding experience alone is not acceptable as a substituteCertification (Required)
One of the following : RHIA, RHIT, CCS, or CPCPreferred Experience
Academic Medical Center coding experienceTrauma Center coding experienceRequired Skills
Expert knowledge of :ICD-10-CM, ICD-10-PCS, MS-DRGs, POA, APCsStrong analytical and problem-solving skillsExcellent written and verbal communicationTraining and mentoring capabilityProficiency in Microsoft Office and coding systemsAbility to work independently and within teams