Inpatient Audit Specialist

Accountabilities:

Conduct inpatient facility coding audits across various engagement types, including onboarding reviews, focused audits, service-level agreement assessments, and other specialized evaluations.
Review medical records and validate appropriate coding assignments and related documentation elements using MS-DRG or APR-DRG methodologies.
Identify coding discrepancies, documentation gaps, and compliance issues, providing detailed and concise explanations for recommended changes.
Support audit findings with accurate references, including specific documentation locations and relevant coding guidelines, to ensure transparency and consistency.
Monitor regulatory updates, industry standards, and changes in coding guidelines to maintain accuracy and compliance throughout all auditing activities.
Manage multiple client assignments simultaneously, organizing and prioritizing cases to meet established productivity targets and turnaround times.
Deliver constructive coding education and feedback through the auditing process, helping coding professionals improve their knowledge, accuracy, and performance.
Provide consulting and educational support related to coding quality, compliance assessments, external payer reviews, and coding workflow operations.
Identify potential solutions to client challenges and communicate audit results and recommendations in a clear, professional, and customer-focused manner.
Maintain high standards of productivity, accuracy, and quality while independently managing daily workloads and meeting established performance expectations.
Collaborate effectively with internal teams, clients, and coding professionals to support continuous improvement and consistent service delivery.
Uphold professional and ethical standards, including adherence to the American Health Information Management Association (AHIMA) Code of Ethics.
Requirements:
At least 5 years of experience in inpatient facility medical coding and/or coding auditing, with strong knowledge of hospital coding practices and documentation requirements.
Professional certification such as Certified Coding Specialist (CCS), Registered Health Information Administrator (RHIA), or Registered Health Information Technician (RHIT); CCS certification is preferred.
Demonstrated expertise in inpatient coding methodologies, including MS-DRG and APR-DRG assignment, with the ability to maintain a minimum DRG accuracy rate of 95%.
Strong knowledge of coding regulations, compliance standards, documentation requirements, and applicable healthcare industry guidelines.
Experience working with electronic medical record systems and coding software, particularly Epic, Cerner, and other commonly used EMR platforms.
Excellent query-writing skills and the ability to formulate clear, accurate, and well-supported documentation queries. Previous spinal coding experience is considered an advantage.
Strong analytical, critical-thinking, and problem-solving abilities, with sound judgment when evaluating complex medical records and coding decisions.
Proven ability to manage multiple clients and assignments simultaneously while maintaining accuracy, productivity, and consistent quality standards.
High degree of independence, initiative, and accountability, with the ability to prioritize tasks and manage workloads effectively with minimal supervision.
Excellent organizational and time-management skills, with the ability to remain focused, minimize non-productive time, and consistently meet performance expectations.
Strong written and verbal communication skills, including the ability to explain audit findings and provide constructive feedback to coding professionals and clients.
A professional, customer-oriented approach, demonstrating flexibility, dependability, teamwork, and a commitment to continuous learning and excellence.
Ability to work effectively in a fully remote environment while maintaining productivity and professional engagement.
Benefits:
Competitive compensation: Estimated hourly pay range of $35–$45 USD, depending on experience, qualifications, location, and role responsibilities.
Sign-on bonus: $2,500 for eligible new hires.
Comprehensive healthcare coverage: Medical, dental, and vision insurance.
Retirement savings: 401(k) plan with employer matching contributions.
Paid time off: Two weeks of paid vacation, in addition to paid holidays and floating holidays.
Professional development: Free continuing education units (CEUs) provided annually.
Education and professional support: Financial stipend to help cover eligible educational expenses and professional membership dues, including AHIMA and AAPC fees.
Remote work flexibility: Fully remote position with a flexible schedule, allowing you to work from your preferred location within the United States.
Work equipment provided: Laptop, monitor, mouse, headset, and keyboard supplied to support your remote working environment.
Comprehensive onboarding: Structured training led by an experienced, credentialed professional coding manager.
Ongoing mentorship: Supportive management, professional guidance, and opportunities to learn from experienced healthcare coding specialists.
Collaborative culture: Opportunity to contribute to meaningful healthcare data quality and compliance initiatives while working with a supportive professional team.