Certified Inpatient Coding Auditor

Job Summary

A company is looking for a Nurse Inpatient Coding Auditor, (Remote) CIC or CCS certified.

Key Responsibilities

• Audits and analyzes neonatal intensive care unit (NICU) claims according to ICD-10 coding principles and clinical guidelines
• Performs clinical reviews of medical records to validate claims coding accuracy and medical necessity
• Researches reimbursement regulations to support audit findings and assists in developing claims audit process documentation

Required Qualifications

• Registered Nurse required
• 2+ years of experience with inpatient claims, preferably NICU and maternity
• Inpatient Coding Certification (CCS or CIC) required, or must obtain within 6 months of hire
• Experience with ICD-9/10CM and understanding of MS-DRG, AP-DRG, and APR-DRG payment systems
• Adherence to official coding guidelines and regulatory compliance standards