Senior Inpatient Coding Auditor
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Job Description
Inpatient coding auditor reviewing medical records, diagnoses, procedures, and DRG assignments. Supporting Gainwell’s healthcare solutions through compliant audits, documentation, and coder training.
Responsibilities:
- Perform audits of inpatient medical record documentation to determine the accuracy of principal and secondary diagnosis, including MCCs and CCs, and procedure codes
- Validate ICD-10 code assignment and sequencing, discharge status, Hospital-Acquired Conditions, POA assignment, and DRG assignment
- Adhere to official coding guidelines, Coding Clinic guidance, and regulatory mandates
- Use advanced ICD-10 coding expertise to substantiate conclusions
- Utilize proprietary auditing systems to document audit determinations and rationale
- Achieve productivity and quality performance standards established by management
- Cross-train to perform reviews of multiple claim types
- Assist management with training new Coding Auditors through monitoring, mentoring, feedback, and education
- Maintain current knowledge of coding guidelines and complete required CEUs to maintain coding certification
- Attend training sessions and scheduled meetings to enhance clinical policy, procedure, rule, and regulation knowledge
Requirements:
- One or more active professional credentials through AHIMA or AAPC (CPC, CCS, COC, RHIA, RHIT); required
- 2+ years of experience in inpatient medical record coding and/or auditing; required
- Demonstrated proficiency in medical record auditing
- Proficiency in ICD-10-CM, ICD-10-PCS, APC, ASC, HCPCS, and CPT coding methodologies
- Thorough understanding of APR-DRG, AP-DRG, and MS-DRG
- Proficiency in computer skills and typing
- Proficiency with Microsoft Windows, Outlook, Excel, Word, PowerPoint, internet browsers, Microsoft Teams, and Zoom
- Ability to work remotely within the U.S.
Benefits:
- Benefits on the first day of employment
- Clear path for advancement with training and leadership opportunities
- Generous, flexible vacation policy
- 401(k) employer match
- Comprehensive health benefits
- Educational assistance
- Leadership and technical development academies
- Work flexibility
- 0-10% travel
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