Inpatient Coding Data Quality Auditor/Educator

Tasks

• Adhere to AHIMA standards of ethical coding
• Communicate coding corrections to coders and provide educational rationale
• Continuously evaluate clinical documentation quality
• Ensure accuracy sequencing and adherence to coding guidelines
• Escalate documentation concerns as needed
• Identify incomplete or inconsistent documentation impacting code selection and reimbursement
• Monitor coding staff for potential violations and report concerns
• Perform daily data quality reviews on inpatient records
• Prepare written rebuttals for DRG reassignments and appeals
• Provide documentation to third party payers for compliance and accurate reimbursement
• Review physician queries and follow up on timely responses
• Review target cases including OIG focused DRGs and transfer DRGs
• Use audit tracking tools to identify coding error types
• Validate ICD 10 diagnosis and procedure codes
• Verify DRG assignment accuracy and appropriateness

Perks/Benefits

• Dental insurance
• Disability insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Health savings account
• Pension plan
• Professional development
• Vision insurance

Skills/Tech-stack

Anatomy and physiology | CMS coding regulations | Clinical Documentation | Clinical documentation quality | Coding Clinic | Coding guidelines | Coding regulations | DRG assignment | Documentation quality | Electronic Health Record | Encoder systems | Epic Electronic Health Record | Health information | Health information management | ICD-10 | ICD-9 | Information Management | Medicaid billing | Medical coding | Medical coding guidelines | Medical terminology | POA guidelines | Payer compliance | Physician query management | Query management | Third Party | Third Party Payer | Third party payer compliance