Clinical Coding Auditor

Job Summary

Focusing on Coding & Clinical Chart Validation, the full-time Clinical Coding Auditor will analyze and audit inpatient claims, ensuring coding accuracy and appropriateness of treatment settings while utilizing proprietary auditing tools.

Key responsibilities

• Analyzes and audits claims using advanced ICD-10 coding expertise and clinical guidelines
• Utilizes proprietary auditing systems to make determinations and generate audit letters
• Maintains production and accuracy standards set by the audit operations management team

Required qualifications

• Associate or bachelor's degree in nursing or Health Information Management (RHIA or RHIT)
• 5 to 7+ years of experience with ICD-9/10CM, MS-DRG, AP-DRG, and APR-DRG
• Certification in coding/CDI (e.g., RHIA, RHIT, CPC, CCS, CIC, CDIP, or CCDS)
• Proficiency in Word, Access, Excel, TEAMS, and other applications
• Expert knowledge of coding guidelines and compliance regulations