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AI Summary

The Inpatient Auditor conducts prebill audits for facility coders to ensure accuracy, compliance with CMS regulations, and adherence to official coding guidelines. They also provide targeted education and feedback to the coding team to support continuous quality improvement.

The Facility Inpatient Coding Auditor is responsible for prebill audits for inpatient facility coders with a focus on accuracy, compliance, and quality, while providing education and feedback to coding and QA team members. This role ensures adherence to official coding guidelines, regulatory requirements, and organizational standards, and supports continuous improvement through targeted education, data analysis, and collaboration.



Coding Audit & Compliance

  • Conduct comprehensive audits of inpatient facility coding, including MS-DRGs, ICD-10-CM/PCS, POA indicators, discharge disposition, query opportunities, and quality-related data elements  
  • Ensure compliance with official coding guidelines, CMS regulations, payer requirements, and internal policies  
  • Identify coding errors, trends, and root causes impacting reimbursement, quality metrics, and compliance risk  
  • Validate documentation supports coded diagnoses and procedures

Additional Role Details

  • Long term assignment 
  • Schedule: Full-time availability is strongly preferred. However, part-time candidates (20+ hours per week) may be considered for the right individual.

Requirements

  • Active coding credential: RHIA, RHIT, CCS (required)
  • Minimum 3 years of inpatient facility auditing experience
  • Expert knowledge of ICD-10-CM/PCS, MS-DRGs, POA indicators, and UHDDS
  • Strong understanding of CMS regulations, OIG guidance, and compliance standards
  • Experience working with or supporting global or remote coding teams
  • Expected Production of 2 CPH
  • Available for full-time work
  • US based

Skills & Competencies

  • Excellent written and verbal communication skills
  • Strong analytical and critical-thinking abilities
  • Ability to educate and influence without direct authority
  • Cultural awareness and ability to collaborate across time zones
  • Proficiency with Microsoft Office   

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