Outpatient Coding Quality Audit Coordinator

BJC HealthCare • St. Louis, MO

16d • Remote

About The Position

The Outpatient Coding Quality Auditor is responsible for second-level coding audits and real-time education supporting ongoing quality assurance activities for the Coding Department. Audits assess compliance with federal and state regulatory coding guidelines and focus on accurate assignment of diagnoses, procedures, and modifiers for reimbursement and clinical services, including quality measures. The role covers outpatient services across BJC’s health system, including critical access, community, and academic hospitals serving pediatric and adult populations. Audit findings are analyzed to identify risk areas and develop educational materials, such as individualized coder development plans, regulatory updates, and for-cause education.

The coordinator serves as a subject matter and decision-support expert for Enterprise Coding, participates in committees and project teams, and supports issue resolution and process improvement. The position develops and delivers coding education and completes timely, accurate audits using OPPS, ICD-10-CM, and CPT/HCPCS coding systems. It also maintains collaborative relationships with relevant departments and stakeholders. This is a remote position, eligible in the states listed in the posting.

Requirements

• 2–5 years of outpatient coding experience in a hospital environment.
• High school diploma or GED.
• One of the following certifications: RHIT, CCS, CPC, or RHIA.
• Certified Outpatient Coder credential is listed under licenses and certifications.
• Knowledge and application of OPPS, ICD-10-CM, and CPT/HCPCS coding systems and applicable regulatory and payer guidelines.

Nice To Haves

• Associate's degree.
• Bachelor's degree.
• 5–10 years of experience.

Responsibilities

• Serve as a subject matter and decision-support expert for Enterprise Coding.
• Participate in committees, project teams, and meetings to support issue resolution, process improvement, and process development.
• Proactively identify issues or trends and report them to Coding Leadership as appropriate.
• Develop and deliver focused coding education, training plans, and tools addressing risk areas, regulatory updates, and opportunities to improve coding and compliance outcomes.
• Complete timely and accurate quality-assurance coding audits in accordance with OPPS using ICD-10-CM and CPT/HCPCS Coding Classification Systems.
• Adhere to federal and state regulatory and payer guidelines.
• Translate audit results into practical recommendations to improve and standardize audit policies and procedures.
• Build and maintain collaborative relationships within the department and with Quality, Compliance, Revenue Management, providers, and other departments.

Benefits

• Comprehensive medical, dental, vision, and life insurance, and legal services available the first day of the month after hire.
• Disability insurance paid for by BJC.
• Annual 4% BJC Automatic Retirement Contribution.
• 401(k) plan with BJC match.
• Tuition assistance available on the first day.
• BJC Institute for Learning and Development.
• Health Care and Dependent Care Flexible Spending Accounts.
• Paid Time Off combining vacation, sick days, holidays, and personal time.
• Adoption assistance.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED