Inpatient Coding Auditor

Job Overview The Inpatient Coding Auditor will audit inpatient coders and offshore audit teams 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 auditor reports to the Huron Managed Services Domestic Coding team. Responsibilities Demonstrate Huron’s Vision and Values in all behaviors, practices, and decisions. Audit inpatient coders and/or offshore auditors to achieve a minimum of 95% coding accuracy and DRG accuracy. Perform quality checks and calibration audits on visits coded per client SOPs. Suggest improvements and schedule calibration sessions with offshore 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 a firm understanding of clinical documentation guidelines. Monitor compliance with coding guidelines, correct identified errors, and initiate corrective action before claims are rebilled. Conduct analysis and present summaries of findings to leadership in a clear, concise, and actionable format. Utilize encoder software applications and online tools for the assignment of ICD-CM, ICD-PCS, MS-DRG, APR DRG, POA, SOI, and ROM codes. Ensure capture/reporting of appropriate codes using CDC, ICD-CM official guidelines, CMS ICD-PCS guidelines, AHA coding clinic, AHIMA standards, and client procedures. Navigate patient health records and computer systems to determine diagnoses, procedures, and relevant indicators affecting reimbursement. Review inpatient documentation to assess the presence of clinical evidence supporting diagnoses and DRG assignments. Maintain high professional and ethical standards. Update coding skills and knowledge through team meetings, conferences, and CEUs as required. Stay current on inpatient reimbursement guidelines, regulations, and new coding applications (e.g., Hospital at Home). Ensure patient information accuracy and appropriate signatures on all medical records. Apply compliant coder query practices when consulting with physicians, clinical documentation specialists, or other providers. Maintain knowledge of applicable coding and reimbursement laws, regulations, and ethical policies. Perform other duties as assigned. Qualifications Current permanent United States work authorization. Able to work in the United States on a day‑shifts schedule. Minimum 2 years of experience as an inpatient coding auditor. Minimum 3 years of experience in coding inpatient hospital accounts. Advanced proficiency with Microsoft Office (Excel, Word, PowerPoint, Outlook, Visio, SharePoint). Strong analytical, problem‑solving, and workflow skills. Exceptional attention to detail with strong follow‑up and follow‑through. Excellent time‑management skills; organized and able to prioritize multiple tasks on schedule. Independent judgment, discretion, and decision‑making ability. Professional interaction skills with internal and external customers. Rapid ramp‑up on a client’s environment, processes, and systems. Financial acumen and analytical skills. Preference for experience working with data from various sources. Familiarity with revenue cycle systems and deep understanding of revenue cycle process flow. Team‑oriented mindset with desire to collaborate in partnership roles. Strong oral and written communication skills; self‑motivated and able to work independently. Flexible and adaptable to change. Physical demands: seated at a desk/computer for 8 hours daily, repetitive use of keyboard and mouse, use of monitors for 8 hours daily, occasional video/audio calls, occasional ability to lift up to 20 pounds, bending, and standing for periods. Technical Qualifications Required: Certified Coding Specialist (CCS) or Certified Inpatient Coder (CIC) or Certified Documentation Improvement Practitioner (CDIP). Preferred: AHIMA microcredential “Auditing: Inpatient Coding (AIC)” or RHIA; encoder experience (3M/Solventum, Encoder Pro, Codify); Epic, Cerner, or Meditech experience. Key Performance Indicators Coding auditing productivity: ≥ 95% DRG accuracy rate: ≥ 95% Coding accuracy: ≥ 95% Query compliance: 100% adherence to AHIMA/ACDIS standards. Compensation & Benefits Pay range: $26.44–$36.06 per hour. Eligible for Huron benefit plans, including medical, dental, and vision coverage and wellness programs. Pay range information complies with applicable state and local salary transparency laws. EEO 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