Inpatient QA Coder Auditor
The Inpatient QA Coder Auditor is responsible for reviewing and auditing inpatient medical coding for accuracy, compliance, and adherence to regulatory and client-specific guidelines. This role ensures high-quality coding standards, identifies gaps, and provides actionable feedback to coders to drive continuous improvement and coding integrity.
Key Responsibilities
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Perform quality audits on inpatient coding (ICD-10-CM/PCS) to ensure accuracy and compliance with official coding guidelines
Review medical records and validate appropriate assignment of diagnoses and procedures
Identify coding errors, trends, and opportunities for process improvement
Provide detailed feedback, coaching, and education to coders based on audit findings
Ensure compliance with client requirements, regulatory standards (CMS, AHIMA, AAPC), and internal quality benchmarks
Maintain audit reports, scorecards, and documentation of findings
Participate in calibration sessions and client reviews as needed
Support process improvement initiatives to enhance coding quality and productivity
Qualifications
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Bachelor’s degree in Nursing
Active coding certification (e.g., CCS, CPC, CIC) with valid credentials
Minimum 5 years of inpatient medical coding experience
At least 1–2 years of QA auditing experience in inpatient coding (preferred)
Strong knowledge of ICD-10-CM/PCS coding guidelines and DRG assignment
Experience with coding tools such as Epic, Cerner, 3M Encoder, Meditech
Strong analytical skills with keen attention to detail
Excellent communication and coaching skills