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

• 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

• 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