Inpatient Coding Quality Analyst – Auditor

Job not on LinkedIn

🕒 June 11

🏈 Ohio – Remote

🏈 Ohio – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔎 Auditor

👻 Ghost score 57%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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The Ohio State University, Main Campus

WebsiteLinkedInAll Job Openings

1 - 10 employees

Founded 1870

📚 Education

Education

The Ohio State University, Main Campus is a public research university located in Columbus, Ohio. It offers a comprehensive education with a wide array of undergraduate, graduate, and professional programs. The university is engaged in numerous research initiatives and partnerships, providing opportunities for students, faculty, and industry partners to collaborate. Ohio State promotes a vibrant student life with various academic, recreational, and wellness services to support student needs. It also emphasizes community involvement and leadership development, fostering an inclusive environment on its multiple campuses across Ohio.

📋 Description

• Validate the accuracy, completeness, and compliance of ICD-10-CM/PCS coding and MS-DRG/APR-DRG assignment through random and targeted inpatient medical record audits • Support regulatory compliance, reimbursement integrity, data quality, audit readiness, and institutional quality performance • Evaluate complex clinical documentation and coding scenarios • Resolve inpatient claim and coding edits, including medical necessity, DRG validation, NCCI, and payer-driven edit frameworks • Support denial prevention, mitigation, and appeal activities • Identify and mitigate DRG downgrade risk through targeted pre-bill review, trend analysis, and feedback to coding leadership and CDI partners • Conduct pre-bill and post-bill audits of high-risk, high-dollar, and regulatory-sensitive inpatient cases • Document audit results, trends, and recommendations using IHIS and other abstracting, encoding, and reporting systems • Collaborate with Revenue Cycle, Central Business Office, CDI, Compliance, Internal Audit, and clinical stakeholders • Provide expert guidance and education to inpatient coding staff • Participate in formal education sessions and develop coding guidelines, reference materials, and standard operating procedures • Perform 100% pre-bill review of inpatient mortality cases and targeted audits for stroke, cardiac device cases, and selected core measures • Support mortality reporting, institutional quality metrics, and national benchmarking outcomes including Vizient and USNWR rankings • Participate in required coding, quality, audit, and departmental meetings

🎯 Requirements

• Associate degree in Health Information Management, Health Information Technology, or a related field • Minimum of 3–5 years of recent inpatient hospital coding experience in an academic medical center or complex acute-care hospital setting • Proficiency in ICD-10-CM and ICD-10-PCS coding, including validation of principal diagnosis, CCs/MCCs, procedures, POA indicators, and MS-DRG/APR-DRG assignment • Experience reviewing complex inpatient medical records for coding accuracy, compliance, and DRG integrity, including high-severity and high-risk cases • Working knowledge of CMS IPPS regulations, OIG compliance expectations, payer audits, DRG validation, and advanced inpatient claim edit frameworks • Experience using EHRs and health information management systems, including encoder, abstracting, and audit/reporting applications • Ability to apply independent judgment in evaluating coding, documentation, compliance risk, and audit findings • Strong written and verbal communication skills, including the ability to provide clear, educational feedback to coding staff and collaborate with CDI, Revenue Cycle, Quality, and Compliance partners • One of the following credentials required: RHIA, RHIT, or CCS (AHIMA) • Certification must be maintained in good standing • Maintain required continuing education credits (CEUs) in accordance with AHIMA credential standards • Complete mandatory health system training and hospital-based learning modules (CBLs) • Maintain current knowledge of inpatient coding guidelines, regulatory updates, and compliance initiatives • Successful completion of a background check; drug screen or physical may be required during the post-offer process

🏖️ Benefits

• Regular position • 40 scheduled hours • First shift • Remote work arrangement • Equal opportunity employer, including veterans and disability