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Job Description
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The Coding Auditor will perform inpatient coding quality audits and reviews of internal coders and auditors to promote coding accuracy, consistency, and compliance with established coding guidelines and regulatory requirements. This role also supports ongoing quality improvement through the identification of coding trends and educational opportunities.
Key Responsibilities:
- Perform coding audits and quality reviews of UASI internal coders and auditors across a variety of inpatient facility record types, utilizing client documentation and applicable coding guidelines, client-specific requirements, and established audit standards.
- Advanced knowledge and demonstrated auditing experience across the full range of inpatient facility coding, including ICD-10-CM/PCS code assignment and sequencing, Present on Admission (POA) indicators, discharge disposition, and MS-DRG and APR-DRG assignment, including associated CC/MCC, SOI, and ROM impacts. Experience must include auditing complex inpatient cases across a broad range of diagnoses, procedures, and service lines, with the ability to evaluate coding accuracy, documentation support, and appropriate application of official coding guidelines and regulatory requirements.
- Ability to run reports and provide audit score results; identify and analyze coding trends, patterns, and areas of opportunity; and formulate recommendations for corrective action, education, and ongoing quality improvement.
- Perform necessary research to support audit findings and provide clear, defensible rationale. Examples of this research include AHA Coding Clinic, ICD-10-CM/PCS Official Guidelines for Coding and Reporting, the AHA Coding Handbook, and other authoritative coding resources.
- Provide education, feedback, and coaching to internal coders and auditors, as well as in-service education to clients as requested, based on audit findings, identified coding trends, and performance or educational opportunities.
- Participate in peer review, audit-the-auditor, calibration, and other quality assurance activities to promote consistency, accuracy, and standardization across the auditing team.
- Assist in the development and delivery of educational programs and training for clients and staff, including initiatives designed to strengthen coding knowledge, expand coding competencies, and support coder development and progression into inpatient coding roles.
- Maintain current knowledge of inpatient coding guidelines, regulatory requirements, industry guidance, and changes affecting coding and auditing practices.
- Work with other members of the HIM Consulting Division on Senior Level Projects such as ICD-10 assessment and analysis, development of tools to assist in the audit process, development of education for staff, develop coding test material for applicants, and develop coding content for short articles with coding advice for clients.
Qualifications:
- Active RHIA, RHIT, or CCS certification.
- Minimum of 2–5 years of experience performing inpatient facility coding audits and reviews, in addition to previous inpatient coding experience.
- Ability to effectively manage multiple priorities, audit assignments, and deadlines in a fast-paced environment while maintaining accuracy and attention to detail.
- Demonstrated initiative in performing research and maintaining a high level of inpatient coding knowledge and expertise.
- Ability to remain impartial and objective in evaluating, finalizing, and presenting audit findings.
- Willingness to take ownership of responsibilities and deadlines.
- Strong organizational, time-management, and critical-thinking skills.
- Strong computer skills including the ability to utilize UASI audit software and the ability to transfer files in a secure manner in compliance with HIPAA policies and requirements.
- Excellent verbal and written communication skills, including the ability to clearly and confidently communicate audit findings, education, and recommendations in one-on-one, group, virtual, and client-facing settings.
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UASI (operating at uasisolutions.com) is a leading national provider of healthcare revenue cycle management solutions engineered for improving financial outcomes in the mid revenue cycle. Headquartered in Cincinnati, Ohio, UASI partners with healthcare organizations to strengthen financial, clinical, and operational performance through flexible problem-solving and proven expertise. The company specializes in clinical documentation, coding, and Hierarchical Condition Category (HCC) coding, offering managed services, staff augmentation, outsourcing, and interim support. Under the hood, UASI leverages deep industry knowledge and compliance-focused methodologies to ensure accuracy and efficiency in reimbursement processes. This allows healthcare facilities to achieve correct reimbursement in the quickest possible time while maintaining high standards of compliance and accuracy. With over 40 years of experience, UASI is led by Health Information Management (HIM) and Clinical Documentation Improvement (CDI) experts, delivering tailored solutions to meet the evolving needs of the healthcare sector.
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