Job Summary
We are seeking an experienced Coding Compliance Auditor to perform comprehensive audits of inpatient and outpatient medical records to ensure coding accuracy, regulatory compliance, and appropriate reimbursement. The ideal candidate will have strong inpatient auditing experience, advanced knowledge of ICD-10-CM/PCS and CPT coding, and the ability to provide education and guidance to coding staff.
Responsibilities
- Audit inpatient, ambulatory surgery, observation, and outpatient encounters for coding accuracy and compliance.
- Review and validate ICD-10-CM, ICD-10-PCS, and CPT-4 code assignments.
- Audit complex inpatient cases including trauma, critical care, neurology, and rehabilitation.
- Ensure accurate APR-DRG, SOI/ROM, and POA assignments.
- Monitor coding quality and productivity metrics.
- Provide education, feedback, and support to coding specialists.
- Collaborate with CDI teams, physicians, and clinical staff to resolve documentation and coding issues.
- Conduct focused audits and assist with coding corrections as needed.
- Maintain compliance with AHIMA ethical coding standards and regulatory guidelines.
Required Qualifications
- High School Diploma or equivalent.
- Formal ICD-10-CM, ICD-10-PCS, and CPT-4 training.
- Minimum 2 years of ICD-10-CM/PCS coding and abstracting experience in a Level 1 Trauma Hospital OR 4 years of inpatient hospital coding experience.
- 2–3 years of ambulatory/outpatient coding experience.
- Must have inpatient auditing experience.
- One of the following certifications: CCS, RHIT, RHIA, or CIC.
Preferred Qualifications
- Associate’s or Bachelor’s degree.
- Experience working with CDI teams and coding compliance programs.
- Strong knowledge of hospital reimbursement methodologies and coding regulations.
Schedule
- Flexible schedule within core business hours of 6:00 AM – 6:00 PM.
- Must be available to work within EST or CST business hours.
Company Description
AlphaProTemps is specialized in providing "best-in-class" professional staff augmentation services. These recruiting directives include temporary labor, contract sourcing, professional & technical niches, vendor-on-site, and managed service programs.