JOB SUMMARY:
We are seeking a highly skilled Inpatient Coding Auditor to ensure the accuracy, integrity, and compliance of coding across inpatient and outpatient services. This role serves as a subject matter expert in coding practices and supports education, auditing, and collaboration efforts across clinical and coding teams.
RESPONSIBILITIES:
- Accurately audit inpatient, ambulatory surgery, observation, and outpatient encounters to ensure appropriate reimbursement, regulatory compliance, and data integrity using ICD10CM, ICD10PCS, and CPT4 classification systems
- Review and validate complex inpatient cases including trauma, rehab, neurology, and critical care to ensure accurate APRDRG, SOI, ROM, and POA assignment
- Serve as a coding subject matter expert by analyzing clinical documentation, identifying discrepancies, and collaborating with providers, clinical documentation specialists, and coding staff
- Provide education, training, and ongoing support to Coding Specialists, including onboarding new hires and sharing best practices
- Monitor and report coding accuracy and productivity metrics for coding staff
- Conduct focused and specialized audits as needed to improve coding quality and compliance
- Research new surgical procedures and emerging technologies to support accurate coding practices
- Communicate with hospital departments to address coding concerns and ensure alignment with regulatory and organizational standards
- Escalate coding issues to leadership in a timely manner with clear and detailed documentation
- Assist coding staff with developing appropriate and compliant coding queries
- Collaborate closely with Clinical Documentation Integrity teams and maintain knowledge of PPCs, MHACs, PQIs, and related quality indicators
- Ensure adherence to AHIMA ethical coding standards and all applicable compliance guidelines
- Support organizational mission, vision, and values, and complete additional coding reviews, corrections, or projects as assigned by leadership
Hours: Operating hours are 6AM to 6PM EST
40 hours per week within the operating timeframe
Required Qualifications
Education
- High School diploma or equivalent required
- Formal training in ICD10CM, ICD10PCS, and CPT4 required
- Associate or Bachelor degree preferred. Relevant education may substitute for experience
Experience
- Minimum 2 years of ICD10CM and ICD10PCS coding and abstracting experience in a Level 1 Trauma hospital OR 4 years of inpatient hospital coding experience
- 2 to 3 years of ambulatory coding experience
- Required: hands on inpatient coding audit experience
Certifications
- One of the following active credential required:
- Certified Coding Specialist CCS
- Registered Health Information Technician RHIT
- Registered Health Information Administrator RHIA
- Certified Inpatient Coder CIC
WORK ENVIRONMENT:
- Fully remote position
- Must have their own equipment to work from
- Must have reliable internet and a secure work environment
- Must be based in EST or CST hours
Choose 1st Choice — we care about our people, offer great benefits, and create real opportunities to grow. With 20+ years of nationwide staffing success, we're here to help you thrive. We’re an equal opportunity employer and welcome all qualified applicants.
Company Description
1st Choice is a professional management consulting firm with more than two decades of experience delivering innovative consulting, technology, and staffing solutions to federal and commercial organizations throughout the United States.
At 1st Choice we embrace diversity of humanity and all it brings to creating an innovative environment. 1st Choice exhibits a compelling workplace through its ethically driven team and diverse academic backgrounds the staff delivers to the organization. We take pride in hiring staff that offers world-class service to support government agencies, corporations, and non-profit organizations nationwide.