Inpatient Coding Data Quality Auditor/Educator

University Hospital, Newark NJ • Newark, NJ

117d • $97,075 - $140,256

About The Position

The main role of the Inpatient Coding Data Quality Auditor/Educator is to support accurate and consistent claim processing and data collection, helping to maximize DRG reimbursement and ensure high-quality data that reflects the complexity of inpatient care. This position involves auditing inpatient coding records, providing ongoing education to coding staff, and streamlining the inpatient coding workflow.

Requirements

• Bachelor’s Degree in Health Information Management or a related field required.
• RHIA or RHIT certification preferred.
• CCS certification required.
• If not CCS certified, must obtain certification from AHIMA within 60 days of hire or the next available exam.
• Minimum of 3 years of hospital inpatient coding experience.
• Experience with ICD-9 and ICD-10 diagnosis and procedure coding.
• Skilled in DRG assignment.
• Preferably experienced in a tertiary care, teaching hospital setting.
• Exposure to complex surgical, transplant, trauma, neurosurgery, Ob/Gyn, and neonatology services.
• Knowledge of medical terminology, anatomy, physiology, and disease processes.
• Familiarity with Coding Clinic, POA indicators, and query guidelines.
• Understanding of CMS, Medicaid, and third-party payer coding, billing, and compliance regulations.
• Experience with encoder systems such as Clintegrity 360 preferred.
• Experience with Epic electronic health record preferred.
• Ability to manage multiple and changing priorities.
• Must be able to read, write, and speak English fluently.
• Excellent verbal and written communication skills required.
• Must be detail-oriented, accurate, and organized.
• Able to work independently.
• Proficient in computer use and internet navigation.
• Skilled in Microsoft Office, especially Excel, Outlook, and shared files.
• Additional related experience may substitute for the degree requirement on a year-for-year basis.

Responsibilities

• Ensure consistent processing of inpatient claims and data collection.
• Optimize Diagnosis-Related Group (DRG) reimbursement.
• Produce high-quality data that accurately reflects the severity and complexity of inpatient hospital services.
• Audit inpatient coded medical records for accuracy and compliance.
• Provide ongoing education and training to all inpatient coding staff.
• Facilitate and improve the workflow of inpatient coding operations.

Benefits

• Paid Time Off (PTO)
• Medical & Prescription Drug Coverage
• Dental & Vision Insurance
• Health Savings Account (HSA) & Flexible Spending Account (FSA)
• Short- & Long-Term Disability Insurance
• Pension Plan
• Pet Insurance
• Employee Assistance Program (EAP)
• Professional Development

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Bachelor's degree
• Number of Employees: 501-1,000 employees