Inpatient Auditor

TEKsystems•Linthicum Heights, MD

6d•$36 - $40•Remote

About The Position

This is a fully remote opportunity with a leading healthcare organization seeking a highly skilled coding professional to audit complex inpatient and outpatient medical records, ensure coding accuracy and compliance, and serve as a subject matter expert for coding teams. This role is ideal for candidates with strong inpatient auditing experience who enjoy quality assurance, education, and collaboration with coding and clinical documentation teams.

Requirements

High School Diploma or GED required.
Formal training in ICD-10-CM, ICD-10-PCS, and CPT-4 coding.
2 years of ICD-10-CM/ICD-10-PCS coding and abstracting experience within a Level I Trauma Hospital, OR 4 years of inpatient hospital coding experience.
2–3 years of ambulatory/outpatient coding experience.
Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), or Certified Inpatient Coder (CIC).
Strong knowledge of ICD-10-CM, ICD-10-PCS, CPT-4, and DRG methodology.
Exceptional analytical and critical thinking skills.
Experience reviewing complex inpatient records for coding accuracy and compliance.
Excellent communication and collaboration skills.
Ability to work independently in a fully remote environment while maintaining productivity and quality standards.

Nice To Haves

Associate's or Bachelor's degree preferred (education may be considered in lieu of some experience).
Experience auditing complex inpatient cases preferred.

Responsibilities

Audit inpatient, ambulatory surgery, observation, and outpatient encounters to ensure accurate reimbursement and compliance with federal and state regulations.
Review and validate ICD-10-CM, ICD-10-PCS, and CPT-4 coding assignments.
Audit complex inpatient cases including trauma, neurology, rehabilitation, critical care, and other high-acuity services.
Ensure accurate APR-DRG, SOI/ROM, and POA assignments.
Analyze clinical documentation and identify coding opportunities or discrepancies.
Serve as a coding subject matter expert and resource for Coding Specialists.
Conduct focused audits and quality reviews as needed.
Monitor coding accuracy and productivity metrics.
Provide coaching, education, and training to coding staff and new hires.
Research new procedures, surgical techniques, and emerging healthcare technologies.
Partner with Clinical Documentation Integrity (CDI) teams and providers to improve documentation quality.
Assist coding specialists with creating appropriate coding queries.
Collaborate with hospital departments regarding coding accuracy and compliance concerns.
Understand and apply concepts related to Potentially Preventable Complications (PPCs), Maryland Hospital Acquired Conditions (MHACs), Prevention Quality Indicators (PQIs), and related quality measures.
Maintain adherence to AHIMA ethical coding standards and coding compliance guidelines.
Stay current on coding regulations, payer requirements, and industry updates.