Inpatient Coding Auditor

About the Role Huron helps its clients drive growth, enhance performance, and sustain leadership in the markets they serve. We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, enabling them to own the future instead of being disrupted by it. Together, we empower clients to create sustainable growth, optimize internal processes, and deliver better consumer outcomes. Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and reduce the cost of providing patient care. Investing in new partnerships, clinical services and technology is not enough to create meaningful and substantive change. To succeed long-term, healthcare organizations must empower leaders, clinicians, employees, affiliates and communities to build cultures that foster innovation to achieve the best outcomes for patients. Joining the Huron team means you’ll help our clients evolve and adapt to the rapidly changing healthcare environment and optimize existing business operations, improve clinical outcomes, create a more consumer‑centric healthcare experience, and drive physician, patient and employee engagement across the enterprise. Key Responsibilities Knows, understands, incorporates, and demonstrates Huron’s Vision and Values in behaviors, practices, and decisions. Audits inpatient coders and “audit the auditors” to ensure coding accuracy and DRG accuracy of a minimum of 95%. Performs quality checks/audits on visits coded as per client SOPs. Conducts calibration audits. Suggests improvements and schedules calibration sessions with offshore team counterparts and leaders. Assists in preparing audit reports, shares direct feedback to coders and auditors on areas of opportunity, and participates in client interactions and internal stakeholder meetings. Manages understanding of clinical documentation guidelines. Monitors compliance with coding guidelines, identifies errors, initiates corrective action before claims are rebilled. Conducts analysis and presents a summary of findings to leadership in a clear, concise, convincing, and actionable format. Utilizes encoder software applications and online tools for ICD‑CM, ICD‑PCS, MS‑DRG, APR‑DRG, POA, SOI & ROM assignments. Ensures proper capture/reporting of appropriate codes via CDC, CMS, AHA, AHIMA Standards of Ethical Coding, and client coding procedures. Navigates patient health records and other computer systems to accurately determine diagnosis and procedure codes, MS‑DRGs, APR‑DRGs, and identify HACs and PSIs that could impact quality data and hospital reimbursement. Reviews inpatient health record documentation to assess the presence of clinical evidence supporting diagnosis codes and DRG assignments to potentially decrease denials. Maintains professional and ethical standards and updates knowledge by participating in coding team meetings and educational conferences. Maintains CEUs as required for coding credentials. Stays current with changes in inpatient reimbursement guidelines and regulations, as well as new applications (e.g., Hospital at Home). Ensures patient information is correct and signatures are on all medical records. Demonstrates knowledge of current coder query practices when consulting with physicians, CDS or other healthcare providers. Maintains a working knowledge of applicable coding and reimbursement laws, Code of Ethics, and other policies and procedures. Performs other duties as assigned. Core Qualifications Current permanent United States Work Authorization. Working in the United States Day shift schedule. 2+ years previous experience as an inpatient coding auditor. 3+ years previous experience in coding inpatient hospital accounts. Advanced proficiency with Microsoft Office suite (Excel, Word, PowerPoint, Outlook, Visio, SharePoint). Analytical skills (problem solving, quantitative, workflow process, etc.). Attention to detail and strong follow‑up skills. Excellent time‑management skills; organized; able to prioritize multiple tasks in a deadline‑driven environment. Use of independent judgment, discretion, and decision‑making abilities. Professional interaction with internal and external customers. Ability to ramp up on a client’s environment, processes, historical context, and systems quickly. Financial acumen and analytical skills. Experience working with data from various sources. Familiarity with revenue cycle systems and deep understanding of revenue cycle process flow. Desire to work as part of a team in a partnership role. Strong oral and written communication skills, analytical skills, ability to work independently, and self‑motivation. Flexible and adaptable to change. Physical Demands Remaining seated at a desk/computer for 8 hours daily; repetitive use of computer keyboard and mouse; use of computer monitors for 8 hours daily; interaction via video/audio conference calls and possible use of a headset with microphone. Very rarely duties might require the ability to lift up to 20 pounds and bend & stand for periods at a time. Technical Qualifications Required Certifications: Certified Coding Specialist (CCS) or Certified Inpatient Coder (CIC) or Certified Documentation Improvement Practitioner (CDIP). Preferred Certifications: AHIMA microcredential “Auditing: Inpatient Coding (AIC)”; RHIA preferred. Encoder experience (3M/Solventum, Encoder Pro, Codify) preferred. Epic, Cerner, and Meditech experience preferred. Key Performance Indicators (KPIs) – Expectations Coding Auditing Productivity: ≥ 95% DRG Accuracy Rate ≥ 95% Coding Accuracy: ≥ 95% Query Compliance: 100% adherence to AHIMA/ACDIS standards Benefits The estimated pay range for this job is $26.44 – $36.06 per hour. This range represents a good faith estimate of the range that Huron reasonably expects to pay for this job at the time of the job posting. The actual salary paid to an individual will vary based on multiple factors, including but not limited to specific skills or certifications, years of experience, market changes, and required travel. This job is also eligible to participate in Huron’s benefit plans which include medical, dental and vision coverage, and other wellness programs. The pay range information provided is in accordance with applicable state and local laws regarding salary transparency that are currently in effect and may be implemented in the future. 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