Coding Auditor

Minimum Qualifications:

• 5 years coding experience in an acute care facility
• Expert-level knowledge of medical terminology, anatomy and physiology, ICD-10-CM/PCS, CPT, and HCPCS coding conventions, and CMS coding requirements
• Proficient in word processing and PC based spreadsheet program including Excel and PowerPoint
• Ability to research coding questions and use educational resources

Licensure/Registration/Certification

• AHIMA credentialed as one of the following:  Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), OR Certified Coding Specialist (CCS)

Desired Qualifications:

• Associate's degree

This role is not as a traditional coder. *This position is remote*

Daily responsibilies include:

• Ensures compliance with official coding guidlines, CMS regulations, payer requirements, and internal IH policies.
• Conducts comprehensive coding reviews/audits to identify errors, trends, and root causes impacting reimbursement, quality metrics, and compliance; includes internal/external audits, coding denials, CDI/Quality findings.
• Provides coder feedback and coaching based on audit findings; prepares and distributes audit results and coding performance reports.
• Creates and maintains educational materials, job aids, and coding guidance updates.
• Develops and delivers coding education (both in‑person and virtual). Supports onboarding and ongoing competency development for new and experienced coders.
• Acts as a coding resource to other departments such as Case Management, CDI, and Insurance Authorization.
• Ensures data reliability and appropriate reimbursement by maintaining current expertise in ICD‑10‑CM/PCS, CPT, and HCPCS conventions and CMS directives; actively participates in education.