Inpatient Coding Data Quality Auditor/Educator

University Hospital, Newark NJ-posted 2 months ago
$97,075 - $140,256/Yr
Full-time • Mid Level
Newark, NJ
501-1,000 employees
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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.

  • 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.
  • 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.
  • 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
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