Key Responsibilities Perform activity related to coding of medical records, resolve coding‑related denials, and audit coders to ensure coding accuracy standards are met.
Demonstrate Huron’s Vision and Values in all behaviors, practices, and decisions.
Act as Inpatient Coding Auditor, ensuring a minimum 95% accuracy for coding and DRGs.
Conduct quality checks/audits on visits coded according to client SOPs.
Perform calibration audits and schedule calibration sessions with offshore team counterparts and leaders.
Assist in preparing audit reports, providing direct feedback to coders and auditors, and participate in client interactions and internal stakeholder meetings.
Possess a firm understanding of clinical documentation guidelines.
Identify and rectify coding guideline violations during audits before claims are rebilled.
Analyze and present audit findings to leadership in a clear, concise, actionable format.
Use encoder software applications and all available online tools for assignment of ICD‑CM diagnosis codes, procedures, MS‑DRG, APR‑DRG, POA, SOI & ROM assignments.
Employ coding guidelines from: The Centers for Disease Control (CDC) and ICD‑CM Official Coding Guidelines for Coding and Reporting
Centers for Medicare/Medicaid Services (CMS) ICD‑PCS Official Guidelines for Coding and Reporting
American Hospital Association (AHA) Coding Clinic for ICD‑CM
American Medical Association (AMA) for CPT codes and CPT Assistant
American Health Information Management Association (AHIMA) Standards of Ethical Coding
Client coding procedures and guidelines
Navigate patient health records and other computer systems to determine diagnosis and procedure codes, and identify HACs, PSIs or other indicators affecting quality data and reimbursement.
Review documentation to verify the presence of clinical evidence supporting diagnosis codes and DRG assignments to reduce denials.
Maintain a high degree of professional and ethical standards.
Update coding skills, knowledge, and accuracy by participating in team meetings and educational conferences.
Obtain and maintain required CEUs for coding credentials as per credentialing associations.
Stay current on changes in inpatient reimbursement guidelines, regulations, and new applications such as Hospital at Home.
Ensure patient information is correct and appropriate signatures are present on all medical records.
Demonstrate knowledge of compliant coder query practices when consulting with physicians, Clinical Documentation Specialists, or other healthcare providers to clarify documentation.
Maintain working knowledge of applicable coding and reimbursement laws, regulations, Code of Ethics, and related policies.
Perform additional duties as assigned.
Core Qualifications Current permanent U.S. work authorization.
Day‑shift schedule in the United States.
2+ years experience as an inpatient coding auditor.
3+ years experience in coding inpatient hospital accounts.
Advanced proficiency with Microsoft Office Suite (Excel, Word, PowerPoint, Outlook, Visio, SharePoint).
Analytical skills (problem solving, quantitative analysis, workflow process).
Strong attention to detail and follow‑through skills.
Excellent time‑management skills, organized, able to prioritize tasks in a deadline‑driven environment.
Independent judgment, discretion, and decision‑making abilities.
Professional communication skills with internal and external customers.
Rapid ramp‑up ability to client environments, processes, and systems.
Financial acumen and analytical skills.
Experience working with data from various sources.
Familiarity with revenue cycle systems and deep understanding of revenue cycle processes and financial analysis.
Team‑oriented mindset in a partnership role.
Strong oral and written communication, independent work, and self‑motivation.
Flexibility and adaptability to change.
Physical Demands Remain seated at a desk/computer for 8 hours daily; repetitive use of keyboard, mouse, and monitors; occasional headset use for video/audio calls; rarely required to lift up to 20 lbs and bend/stand periodically.
Technical Qualifications Required certifications: Certified Coding Specialist (CCS), Certified Inpatient Coder (CIC), or Certified Documentation Improvement Practitioner (CDIP).
Preferred certifications: AHIMA micro‑credential “Auditing: Inpatient Coding (AIC)”; RHIA preferred.
Encoder experience (3M/Solventum, Encoder Pro, Codify) preferred.
Epic, Cerner, Meditech experience preferred.
Key Performance Indicators (KPIs): Coding Auditing Productivity ≥ 95 %
DRG Accuracy Rate ≥ 95 %
Coding Accuracy ≥ 95 %
Query Compliance: 100 % adherence to AHIMA/ACDIS standards
Estimated Pay Range : $26.44 – $36.06 per hour.
Position Level : Analyst
Country : United States of America
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