Certified Inpatient Coding Auditor

Virtual Vocations Inc; United States; On-site; USD 70,000 - 100,000; Full time

Job summary

DaMar Staffing is seeking a full-time remote Certified Inpatient Coding Auditor to perform clinical reviews of medical records, ensuring claims coding accuracy and compliance with regulatory guidelines.

You will audit NICU claims, verify medical necessity, and help document the audit process while staying current with DRG and ICD-10 coding conventions.

Qualifications

• RN with 2+ years in inpatient claims, NICU/maternity preferred.
• CCS or CIC certification required or within 6 months of hire.
• Strong DRG, ICD-10, CPT, HCPCS coding knowledge and appeals experience.

Responsibilities

• Audit NICU claims for ICD-10 coding accuracy.
• Ensure compliance with ethical coding and medical necessity requirements.
• Research reimbursement regulations and help develop audit documentation.

Skills

Inpatient coding

Auditing

DRG knowledge

ICD-10/CPT/HCPCS coding

Regulatory compliance

Education

Registered Nurse license

Inpatient coding certification (CCS or CIC)

Job description

To support a culture of continuous improvement, the full-time remote Certified Inpatient Coding Auditor will perform clinical reviews of medical records, ensuring claims coding accuracy and compliance with regulatory guidelines.

Key responsibilities:

• Audits and analyzes neonatal intensive care unit (NICU) claims according to ICD-10 coding principles
• Ensures claims analysis complies with ethical coding standards and validates issues of medical necessity
• Researches reimbursement regulations and assists in developing claims audit process documentation

Required qualifications:

• Registered Nurse with 2+ years of experience in inpatient claims, preferably NICU and maternity
• Inpatient Coding Certification (CCS or CIC) required, or must obtain within 6 months of hire
• Strong understanding of MS-DRG, AP-DRG, and APR-DRG payment systems
• Expert knowledge of DRG, ICD-10, CPT, and HCPCS codes
• Experience with appeals and familiarity with medical claims billing/payment systems