Medical Coding Auditor – Inpatient, OIG Focus

Job Description: • 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. • Work closely with medical billing, compliance, and clinical teams to ensure that coding supports accurate billing and reimbursement processes. Requirements: • High school diploma or equivalent GED required. • 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, while CPC-H, CPC-P, RHIA, RHIT, or CCS-P are all generally accepted as well. • 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 a plus. • Previous payer experience in a claim processing, edit development, and/or coding and reimbursement policy a plus. Benefits: • medical • dental • vision • HSA/FSA options • life insurance coverage • 401(k) savings plans • family/parental leave • paid holidays • paid time off annually Apply tot his job