Coding Auditor

Overview

Qualifications

Minimum Qualifications

5 years coding experience in an acute care facility Expert-level knowledge of medical terminology, anatomy and physiology, ICD-10-CM/PCS, CPT, and HCPCS coding conventions, and CMS coding requirements Proficient in word processing and PC based spreadsheet program including Excel and PowerPoint Ability to research coding questions and use educational resources Licensure/Registration/Certification AHIMA credentialed as one of the following: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), OR Certified Coding Specialist (CCS) Desired Qualifications: Associate's degree

Responsibilities

• This role is not as a traditional coder. *This position is remote
• Daily responsibilies include: Ensures compliance with official coding guidlines, CMS regulations, payer requirements, and internal IH policies. Conducts comprehensive coding reviews/audits to identify errors, trends, and root causes impacting reimbursement, quality metrics, and compliance; includes internal/external audits, coding denials, CDI/Quality findings. Provides coder feedback and coaching based on audit findings; prepares and distributes audit results and coding performance reports. Creates and maintains educational materials, job aids, and coding guidance updates. Develops and delivers coding education (both in‑person and virtual). Supports onboarding and ongoing competency development for new and experienced coders. Acts as a coding resource to other departments such as Case Management, CDI, and Insurance Authorization. Ensures data reliability and appropriate reimbursement by maintaining current expertise in ICD‑10‑CM/PCS, CPT, and HCPCS conventions and CMS directives; actively participates in education.