Inpatient Coding Compliance Auditor

Gebbs Healthcare Solutions Inc

3d•$36 - $36•Remote

About The Position

GeBBS Healthcare Solutions is seeking an experienced Inpatient Coding Compliance Auditor to join its remote team. The role conducts comprehensive audits of acute care inpatient medical records to ensure accurate coding, regulatory compliance, and appropriate reimbursement. The auditor uses iCodeOne to review ICD-10-CM, ICD-10-PCS, and applicable CPT assignments, evaluates clinical documentation and coding practices, and identifies compliance risks and opportunities to improve coding quality. The position also involves reporting audit findings, collaborating with coding leadership and other teams, educating coding professionals, and staying current with coding guidelines and regulatory updates.

Requirements

At least 4 years of acute care inpatient coding experience, including coding quality or compliance auditing.
Demonstrated expertise in ICD-10-CM, ICD-10-PCS, and CPT coding.
Active CCS, RHIA, or RHIT credential.
Strong understanding of MS-DRGs, IPPS, Medicare reimbursement methodologies, and applicable federal coding guidelines.
Experience auditing inpatient clinical documentation, diagnosis and procedure coding, and reimbursement accuracy.
Ability to identify coding discrepancies and provide actionable recommendations.
Strong analytical, communication, and written reporting skills.
Experience delivering coding feedback, education, and quality improvement recommendations.
Ability to work independently and collaborate effectively with remote teams.
Proficiency with Epic EHR.

Nice To Haves

Bachelor's degree in Health Information Management, Healthcare Administration, or a related field, or equivalent experience.
Experience using iCodeOne or similar coding audit platforms.

Responsibilities

Perform comprehensive audits of acute care inpatient medical records using iCodeOne to validate ICD-10-CM, ICD-10-PCS, and applicable CPT review assignments.
Review inpatient diagnoses, procedures, sequencing, and clinical documentation for coding accuracy and completeness.
Evaluate coding practices for compliance with CMS, OIG, AHIMA, AAPC, payer-specific, and client requirements.
Validate MS-DRG assignments, principal and secondary diagnoses, procedures, and reimbursement accuracy.
Identify coding discrepancies, documentation gaps, compliance risks, and reimbursement opportunities.
Prepare detailed audit reports describing findings, recommendations, and opportunities for improvement.
Collaborate with coding leadership, CDI, and operational teams to resolve discrepancies and strengthen documentation quality.
Provide constructive feedback and education to coding professionals based on audit findings.
Monitor coding quality trends and recommend strategies to improve accuracy, compliance, and overall performance.
Stay current on inpatient coding guidelines, Medicare reimbursement methodologies, and regulatory updates.