Medical Coding Auditor – Inpatient, OIG Focus

Remote role Full-time Open position

Job Description:

Review and audit medical records to ensure accurate coding of diagnoses, procedures, and services using ICD-10, CPT, and HCPCS codes.
Ensure that coding practices comply with federal, state, and payer-specific regulations and guidelines, including HIPAA and CMS standards.
Detect discrepancies and coding errors, provide feedback, and collaborate with coding staff to correct inaccuracies in medical documentation.
Provide training and support to coding staff on best practices, coding updates, and compliance standards.
Prepare detailed audit reports that highlight findings, trends, and areas for improvement.
Work closely with medical billing, compliance, and clinical teams to ensure that coding supports accurate billing and reimbursement processes.

Requirements:

High school diploma or equivalent GED required.
Associate's or Bachelor's degree in Health Information Management, Medical Coding, or a related field preferred.
Active certification is required.
Certified Professional Coder (CPC) and/or Certified Coding Specialist (CCS) are preferred, while CPC-H, CPC-P, RHIA, RHIT, or CCS-P are all generally accepted as well.
At least three (3) years of direct experience in coding/auditing applicable services, and medical chart review for all provider/claim types.
Coding for emergency care, observation, and same day surgery is preferred.
Prior auditing experience desirable in either a provider setting, or payer experience in claim processing, edit development, and/or coding and reimbursement policy a plus.
Previous payer experience in a claim processing, edit development, and/or coding and reimbursement policy a plus.

Benefits:

Apply tot his job Apply To this Job

Further positions