Manager – Inpatient Coding Auditing, Education

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🕒 Maio 15

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The Ohio State University, Main Campus

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1 - 10 funcionários

Fundada em 1870

📚 Educação

Education

A Ohio State University, Main Campus é uma universidade pública de pesquisa localizada em Columbus, Ohio. Oferece uma educação abrangente com uma ampla gama de programas de graduação, pós-graduação e profissionais. A universidade está engajada em inúmeras iniciativas e parcerias de pesquisa, proporcionando oportunidades para estudantes, professores e parceiros da indústria colaborarem. A Ohio State promove uma vida estudantil vibrante com vários serviços acadêmicos, recreativos e de bem-estar para apoiar as necessidades dos estudantes. Também enfatiza o envolvimento comunitário e o desenvolvimento de liderança, promovendo um ambiente inclusivo em seus múltiplos campi em Ohio.

Descrição

• The Associate Director, Inpatient Auditing & Education provides leadership for inpatient coding audits and audit-informed education within a large academic medical center, with a strong emphasis on OIG and CMS compliance, payer denial prevention, coding quality, and hospital quality outcomes. • This role serves as the operational owner of inpatient audit execution and edit governance, including oversight of NCCI and Quadax edits, ensuring audit and edit outcomes are accurate, consistent, and defensible. • The Associate Director translates audit findings, DRG validation trends, denial patterns, and regulatory requirements into targeted education, remediation strategies, and sustained improvements in coding accuracy and documentation integrity. • The position plays a critical role in identifying and mitigating compliance risk, preventing DRG downgrades, and improving performance across key quality metrics, including Hospital-Acquired Conditions (HACs), Patient Safety Indicators (PSIs), mortality indexing, and benchmarking programs such as Vizient and U.S. News & World Report. • Through close collaboration with CDI, Quality leadership, and Physician Advisors, the Associate Director ensures alignment in documentation expectations, coding guidance, and audit standards—supporting ethical coding practices, interdisciplinary consistency, and enterprise-wide risk reduction.

🎯 Requisitos

• Bachelor’s degree in Health Information Management, Nursing, or related field required (Master’s preferred) • RHIA, RHIT, CCS required • CCDS or CDIP preferred • Minimum of 7 years of progressive experience in inpatient coding, CDI, auditing, or compliance in an acute care setting • Advanced or extensive experience (10+ years) preferred • Experience in a complex healthcare system or academic medical center strongly preferred • Demonstrated leadership experience required, including leading complex audit, education, or compliance initiatives across multidisciplinary teams; prior direct people management experience preferred • Advanced knowledge of MS-DRG/APR-DRG methodologies, ICD-10-CM/PCS guidelines, and inpatient coding compliance • Experience in several of the following areas: Regulatory compliance (CMS, OIG, payer audit focus areas) Denial prevention and appeals support Coding edits (e.g., NCCI, claim edit platforms such as Quadax) Audit program development and quality assurance Clinical validation and DRG downgrade risk Quality metrics (PSI, HAC, Vizient, U.S. News & World Report, etc.) • Proven ability to: Lead audit and education programs and drive measurable performance improvement Translate complex audit, regulatory, and denial trends into actionable strategies Collaborate effectively across multidisciplinary teams (Coding, CDI, Quality, Compliance, Revenue Cycle, Physician Advisors) Equivalent combinations of education and experience demonstrating progressive leadership in inpatient coding, auditing, compliance, or CDI will be considered

🏖️ Benefícios

• Medical, dental and vision coverage, with Ohio State paying a significant portion of the cost. • Paid time off, including sick and vacation time and 11 holidays. • State retirement plan or an alternative retirement plan, both with generous employer contributions.