Medical Coding Auditor-Inpatient

Performant Corp • Plantation, FL

70d • $70,000 - $85,000

About The Position

The Medical Coding Auditor-Inpatient is responsible for ensuring the accuracy, integrity, and compliance of medical coding practices within the organization, with a primary focus on Inpatient services. This role involves auditing medical records, coding data, and billing information to verify adherence to coding guidelines and regulations. The Medical Coding Auditor plays a crucial role in minimizing coding errors, preventing fraudulent activities, and ensuring that the organization meets all applicable standards and requirements.

Requirements

• Extensive knowledge of ICD-10, CPT, and HCPCS coding systems.
• Familiarity with healthcare regulations, including HIPAA, CMS guidelines, and payer-specific requirements.
• Understanding of medical terminology, anatomy, and physiology.
• Strong analytical and problem-solving skills.
• Excellent attention to detail and accuracy.
• Effective communication and interpersonal skills.
• Ability to work independently and as part of a team.
• Ability to work remotely from a home office without on-site supervision.
• Proficiency in coding software and electronic health record (EHR) systems.

Nice To Haves

• Associate's or Bachelor's degree in Health Information Management, Medical Coding, or a related field preferred.
• Active certification is required. Certified Professional Coder (CPC) and/or Certified Coding Specialist (CCS) are preferred.
• At least three (3) years of direct experience in coding/auditing applicable services, and medical chart review for all provider/claim types.
• Coding for emergency care, observation, and same day surgery is preferred.
• Prior auditing experience desirable in either a provider setting, or payer experience in claim processing, edit development, and/or coding and reimbursement policy.

Responsibilities

• Review and audit medical records to ensure accurate coding of diagnoses, procedures, and services using ICD-10, CPT, and HCPCS codes.
• Ensure that coding practices comply with federal, state, and payer-specific regulations and guidelines, including HIPAA and CMS standards.
• Detect discrepancies and coding errors, provide feedback, and collaborate with coding staff to correct inaccuracies in medical documentation.
• Provide training and support to coding staff on best practices, coding updates, and compliance standards.
• Prepare detailed audit reports that highlight findings, trends, and areas for improvement.
• Assist in developing and updating coding policies, procedures, and guidelines to ensure ongoing compliance and efficiency.
• Work closely with medical billing, compliance, and clinical teams to ensure that coding supports accurate billing and reimbursement processes.
• Keep abreast of changes in coding regulations, industry trends, and best practices.

Benefits

• Medical, dental, vision, and disability coverage options.
• Life insurance coverage.
• 401(k) savings plans.
• Paid family/parental leave.
• 11 paid holidays per year.
• Sick time and vacation time off annually.

What This Job Offers

• Career Level: Mid Level
• Education Level: Associate degree
• Number of Employees: 1,001-5,000 employees