Coding Compliance Auditor
RemoteUnited States
Job Summary
Audit hospital inpatient, ambulatory surgery, observation, and outpatient encounters for appropriate reimbursement, research, and compliance with federal and state regulations using ICD-10-CM/PCS and CPT-4 coding systems. Serve as a clinical coding subject matter expert to analyze documentation issues with medical staff and specialists, ensuring accurate APR-DRG/SOI/ROM and POA assignments for complex cases. Act as an educator and advisor to coding specialists, providing training, monitoring productivity, and conducting specialized audits. Communicate with hospital departments regarding coding accuracy, assist in writing queries, and address Potentially Preventable Complications and quality indicators. Comply with AHIMA standards and client mission objectives while performing assigned coding corrections.
Required Qualifications
- Must be based in EST or CST hours
- Must have their own equipment to work from
- Must have reliable internet and a secure work environment
- High School graduate or equivalent
- Formal ICD-10-CM, ICD-10-PCS, CPT-4 training
- Associates or Bachelor's degree
- Minimum of two years ICD-10-CM/ICD-10-PCS coding and abstracting experience
- Experience with a Level 1 Trauma hospital
- 4 years of experience with coding inpatient hospital medical records
- 2-3 Years Ambulatory coding experience
- Must have inpatient auditing experience
- Certified Coding Specialist (CCS)
- Registered Health Information Technician (RHIT)
- Registered Health Information Administrator (RHIA)
- Certified Inpatient Coder (CIC)
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