Inpatient Medical Coding Auditor

About This Opportunity

Our talent team is representing a confidential healthcare organization seeking an experienced Inpatient Medical Coding Auditor to join their remote operations. This position focuses on reviewing inpatient hospital claims for proper reimbursement and handling provider disputes in a metrics-driven environment.

As an Inpatient Medical Coding Auditor, you will extract clinical information from medical records and assign appropriate procedural terminology and medical codes (ICD-10-CM, CPT) to patient records. Your work will directly contribute to cost reduction by increasing the accuracy of provider contract payments and ensuring correct claims payment and appropriate diagnosis related group (DRG) assignments.

Responsibilities

• Review inpatient hospital claims for proper reimbursement and MS-DRG accuracy
• Analyze clinical information from medical records and assign appropriate medical codes
• Ensure correct diagnosis related group (DRG) assignments for claims payment
• Handle provider disputes in a result-oriented manner
• Analyze, enter, and manipulate database information
• Respond to and clarify internal requests for medical information
• Perform inpatient coding reviews and audits while maintaining confidentiality standards
• Work independently to determine appropriate courses of action in occasionally ambiguous situations
• Manage multiple priorities in a fast-paced operational environment

What We're Looking For

Required Qualifications:

• RHIA, RHIT, or CCS Certification (must have held at least one of these qualifications for 4+ years)
• MS-DRG coding and auditing experience
• Experience reading and interpreting claims
• Experience performing inpatient coding reviews/audits in health insurance and/or hospital settings
• Working knowledge of Microsoft Office (Word, PowerPoint, Excel)
• Strong attention to detail with ability to work independently
• Ability to handle multiple priorities while maintaining confidentiality
• Excellent written and verbal communication skills

Preferred Qualifications:

• APR DRG coding/auditing experience
• Financial Recovery experience
• Experience in fast-paced, metric-driven operational settings

Work Environment:

• Remote/work from home position based in the United States
• Occasional travel for training or meetings may be required
• Monday-Friday schedule, 8 hours/day, typically between 6AM-6PM
• Dedicated workspace required to protect PHI/HIPAA information
• Minimum internet requirements: 25 Mbps download, 10 Mbps upload (wired cable or DSL recommended)

How We Work With You

When you apply through Get A Job.ai, our recruiting team will review your qualifications and conduct an initial screening. If there's a strong match, we'll submit your profile to our client for consideration. Please do not attempt to contact the client directly, as all communication should flow through our team to ensure the best experience for everyone involved.

The interview process may include pre-recorded voice interviews or SMS text messaging interviews as part of the initial screening stages, followed by additional rounds if selected to move forward.

Pay

Pay information for this role will be discussed during the screening process with our recruiting team.

Equal Opportunity: Get A Job.ai is committed to inclusive hiring practices and equal employment opportunity. We evaluate all candidates based on qualifications and merit.