Coding Quality Auditor

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 required

Associate’s or Bachelor’s degree in HIM / HIT preferred

Experience

5+ years inpatient acute care facility coding experience

3+ years coding auditing, DRG validation, or coding education experience

Strong experience with ICD-10-PCS and trauma coding

Outpatient or professional coding experience alone is not acceptable as a substitute

Certification (Required)

One of the following : RHIA, RHIT, CCS, or CPC

Preferred Experience

Academic Medical Center coding experience

Trauma Center coding experience

Required Skills

Expert knowledge of :

ICD-10-CM, ICD-10-PCS, MS-DRGs, POA, APCs

Strong analytical and problem-solving skills

Excellent written and verbal communication

Training and mentoring capability

Proficiency in Microsoft Office and coding systems

Ability to work independently and within teams