Inpatient Auditor - Coding Integrity Specialist

Position Summary The Inpatient Coding Auditor will be responsible for the auditing of inpatient coders and auditing of offshore inpatient coding auditors to ensure coding accuracy standards are met. This role requires frequent and effective communication via phone, email, and instant messaging with various client teams and payers. The Inpatient Coding Auditor will report to the Huron Managed Services Domestic Coding team. Key Responsibilities Perform a variety of activities involving the coding of medical records, resolving coding related denials, and auditing of coders to ensure coding accuracy standards are met. Demonstrate Huron’s Vision and Values in behaviors, practices, and decisions. Utilize encoder software applications and all applicable online tools to assign ICD-CM diagnosis and procedure codes, MS-DRG, APR DRG, POA, SOI & ROM assignments. Apply coding guidelines established by CDC, CMS, AHA, AMA, AHIMA, and client procedures. Conduct quality checks/audits on visits coded per client SOPs and perform calibration audits. Suggest improvements, schedule calibration sessions with offshore team counterparts and leaders. Assist in preparing audit reports, provide direct feedback to coders and auditors, and participate in client interactions and internal stakeholder meetings. Maintain firm understanding of clinical documentation guidelines and ensure compliance of coding guidelines. Identify and correct errors during audits and initiate corrective actions before claims are rebilled. Analyze and present summary of findings to leadership in a clear, concise, convincing, and actionable format. Navigate patient health record and related systems to determine accurate diagnoses, procedures, and DRG assignments. Review documentation to assess presence of clinical evidence to support codes and reduce denials. Adhere to professional and ethical standards, maintain CEUs, and stay current on inpatient reimbursement guidelines. Perform other duties as assigned. Qualifications Current permanent United States Work Authorization. Working in the United States Day shift schedule. At least 2 years of experience as an inpatient coding auditor. At least 3 years of experience in coding inpatient hospital accounts. Advanced proficiency with Microsoft Office suite (Excel, Word, PowerPoint, Outlook, Visio, SharePoint). Strong analytical skills and problem solving. Attention to detail, strong follow-up and follow-through skills. Excellent time management and ability to prioritize multiple tasks. Independent judgment, discretion, and decision-making abilities. Professional interaction with internal and external customers. Ability to quickly ramp up on client environment, processes, and systems. Financial acumen and analytical skills. Experience with data from various sources. Familiarity with revenue cycle systems and processes. Desire to work as part of a team in a partnership role. Strong written and oral communication skills. Adaptive to change. Physical Demands Require remaining seated at a desk/computer for 8 hours daily; repetitive use of keyboard and mouse; use of computer monitors for 8 hours; interaction through video/audio conference calls and possible use of a headset with microphone. Very rarely duties may require lifting up to 20 pounds and bending & standing for periods. Technical Qualifications Required Certifications: Certified Coding Specialist (CCS) or Certified Inpatient Coder (CIC) or Certified Documentation Improvement Practitioner (CDIP). Preferred Certifications: AHIMA microcredentials “Auditing: Inpatient Coding (AIC)”; RHIA; Encoder experience (3M/Solventum, Encoder Pro, Codify); Epic experience; Cerner experience; Meditech experience. Key Performance Indicators: Coding Auditing Productivity ≥ 95%; DRG Accuracy Rate ≥ 95%; Coding Accuracy ≥ 95%; Query Compliance 100% adherence to AHIMA/ACDIS standards. Position Level Analyst Country United States of America Equal Employment Opportunity Statement Huron is fully committed to providing equal employment opportunity to job applicants and employees in recruitment, hiring, employment, compensation, benefits, promotions, transfers, training, and all other terms and conditions of employment. Huron will not discriminate on the basis of age, race, color, gender, marital status, sexual orientation, gender identity, pregnancy, national origin, religion, veteran status, physical or mental disability, genetic information, creed, citizenship or any other status protected by laws or regulations in the locations where we do business. We endeavor to maintain a drug-free workplace. #J-18808-Ljbffr Huron Consulting Group