Inpatient Medical Coding Auditor

Position Overview

The Medical Coding Auditor extracts clinical information from various medical records and assigns the appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. This role is key in handling provider disputes and appeals for a Fortune 100 company, ensuring accuracy in claims and DRG assignments, and contributing to overall cost reduction. Remote opportunity – 40 hours per week, Monday to Friday.

Key Responsibilities

• Handle provider disputes and appeals as part of the Inpatient Coding Auditor team.
• Contribute to cost reduction by increasing the accuracy of provider contract payments and ensuring correct claims and DRG assignments.
• Analyze, enter, and manipulate data in relevant databases.
• Respond to and clarify internal requests for medical information.
• Follow established guidelines and procedures while making independent decisions regarding work methods.

Required Qualifications

• RHIA, RHIT or CCS Certification – held for at least 4 years.
• MS-DRG and APR-DRG auditing experience.
• Minimum of 1 year of experience reading and interpreting claims.
• Minimum of 3 years performing inpatient coding audits in health insurance and/or hospital settings, including handling coding disputes.
• Working knowledge of Microsoft Office (Word, PowerPoint, Excel).
• Strong attention to detail with the ability to work independently, handle multiple priorities, and maintain confidentiality.
• Excellent written and verbal communication skills.

Preferred Qualifications

• Associate's Degree or higher in Health Information Management (HIM).
• Experience in Financial Recovery.
• Background in a fast-paced, metric-driven operational setting.

Benefits & Perks

• Benefits starting day 1 of employment
• Competitive 401k match
• Generous Paid Time Off accrual
• Tuition Reimbursement
• Parent Leave
• Go365 perks for well-being