Inpatient Coding Quality Analyst

Job Summary

To support the integrity of inpatient coding, the full-time remote Inpatient Coding Quality Analyst will validate the accuracy and compliance of ICD 10 CM/PCS coding and DRG assignments through audits of medical records, while collaborating with various stakeholders to enhance coding practices and mitigate risks.

Key responsibilities

• Conduct random and targeted audits of inpatient medical records to ensure coding accuracy and compliance
• Resolve complex inpatient claim and coding edits, supporting denial prevention and appeal activities
• Provide expert guidance and education to coding staff, contributing to the development of coding guidelines and standard operating procedures

Required qualifications

• Associate degree in Health Information Management, Health Information Technology, or a related field
• 3-5 years of recent inpatient hospital coding experience in an academic medical center or complex acute care hospital setting
• Proficiency in ICD 10 CM and ICD 10 PCS coding, including DRG assignment and compliance
• Experience with CMS IPPS regulations and advanced inpatient claim edit frameworks
• Certification as a Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), or Certified Coding Specialist (CCS)