Inpatient/Outpatient Coding Auditor
Core
Independently audit inpatient and outpatient medical records for coding accuracy, documentation support, regulatory compliance, and reimbursement impact across a large regional health network.
Role type
Senior IC coding auditor (inpatient/outpatient)
Builds
Coding quality assurance and compliance reports for healthcare facilities
Domain
Healthcare / Medical Coding & Compliance
Required skills
ICD-10-CM, ICD-10-PCS, CPT, HCPCS Level II, DRGs, modifiers, bundling rules, documentation review, audit accuracy maintenance, financial impact assessment
Preferred skills
Facility-specific coding education, calibration activities, stakeholder presentation
Technologies
Electronic health records, audit tools
Responsibilities
Independently audit inpatient and outpatient facility coding for accuracy and compliance; Review ICD-10-CM, ICD-10-PCS, CPT, HCPCS Level II, evaluation and management, modifier, bundling, present-on-admission, procedure, and DRG assignments; Identify incorrect, missing, duplicate, unbundled, unsupported, upcoded, or downcoded codes; Document audit findings with supporting authority, financial impact, risk assessment, and recommended corrective actions; Present preliminary and final findings to health information management leadership and stakeholders; Develop and deliver facility-specific coding education and support exit conferences.
Seniority
Senior, hands-on IC