Coding Auditor & Education Advisor (Remote)

Phoebe Putney Health Systems, Inc.; Albany (GA); Remote; USD 70,000 - 90,000; Full time

Job summary

Phoebe Putney Health Systems, Inc. seeks an experienced Acute Inpatient Coding Auditor with hospital inpatient coding and auditing expertise. The role focuses on facility-based inpatient coding, DRG assignment, ICD-10-CM/PCS accuracy, documentation review and compliance.

The candidate will educate physicians and coders, resolve documentation gaps, and ensure adherence to Official Coding Guidelines and payer requirements. Remote work from Georgia may be available for this position.

Qualifications

• Bachelor’s degree in Health Information Management or related field required.
• In lieu of a 4-year degree, an Associate Degree plus 4 years relevant experience acceptable.
• 4–5 years experience with ICD-9, ICD-10 and HCPCS coding in hospital inpatient setting.
• CCS certification required; RHIT/RHIA or ICD-10 trainer preferred.

Responsibilities

• Audit medical records and coding to ensure ICD-10-CM/PCS and HCPCS accuracy for hospital inpatient services.
• Educate physicians and staff to improve documentation quality and coding accuracy.
• Query physicians to resolve incomplete or conflicting information.
• Research audit results and denials to drive corrective actions and training.

Skills

Organizational Skills

Communication Skills

Interpersonal Skills

Analytical

Mathematical

Grammar / Spelling

Read / Comprehend Written Instructions

Follow Verbal Instructions

Basic Computer Skills

Education

Bachelor’s Degree in Health Information Management or related field

Associate Degree + 4 years relevant experience**

Tools

Microsoft Office Suite

Job description

Job Number:30780Location:Remote - GeorgiaStreet Address:Remote AddressCity, State:Remote, GeorgiaZip Code:31701Department:PPHS HEALTH INFORMATION MANAGEMENTShift:First ShiftJob Type:Full timePosted Date:2025-01-21Job Description Summary:Description:We are seeking an experienced Acute Inpatient Coding Auditor with recent acute care hospital experience. This role is responsible for auditing facility-based inpatient coding, DRG assignment, ICD-10-CM/PCS coding accuracy, documentation review, and compliance. Candidates must have a strong background in acute inpatient hospital coding and auditing.This position focuses exclusively on facility (hospital) inpatient services and is not a professional fee/physician coding role.JOB SUMMARY:Audits medical record documentation and coding to extract data and determine appropriate ICD-10-CM/PCS and HCPCS codes for billing, internal and external reporting, and compliance with the Official Coding Guidelines for Coding and Reporting, payer regulations, and hospital policy. Educates physicians and clinical personnel to ensure complete documentation in the medical record and queries physicians to resolve incomplete or conflicting information to ensure compliant coding and billing practices. Educates and trains coders to ensure both a working knowledge of coding and reimbursement guidelines and successful career ladder completion, including the development of training materials and reference documents. Researches audit results, error reports, and denials and resolves by successful appeal, staff education, and correction of discrepancies.GENERAL REQUIREMENTS:Adheres to the hospital and departmental attendance and punctuality guidelinesPerforms all job responsibilities in alignment with the core values, mission and vision of the organizationPerforms other duties as required and completes all job functions as per departmental policies and proceduresMaintains current knowledge in present areas of responsibility (i.e., self education, attends ongoing educational programs)Attends staff meetings and completes mandatory in-services and requirements and competency evaluations on time.WORKING CONDITIONS:General environment: Works in a well-lighted, air-conditioned area, with moderate noise levels.May be required to change from one task to another of different nature without loss of efficiency or composure.Periods of high stress and fluctuating workloads may occur.May be scheduled as needed including overtimeEDUCATION REQUIREMENTS:4 year / Bachelor's Degree in Health Information Management or related medical degree (Required) ;In lieu of a Bachelor's Degree; an Associate Degree and a Minimum of 4 years additional relevant experience is acceptable.EXPERIENCE REQUIREMENTS:4 - 5 years Experience with ICD-9, ICD-10, and HCPCS coding including hospital inpatient medical records (Required4 - 5 years Extensive knowledge of medical terminology, pathophysiology, and pharmacology (Required)4 - 5 years Experience calculating and analyzing MS-DRG, DRG, APC, and other payer reimbursement methodologies (Required)CERTIFICATIONS AND LICENSURES:Required Certifications/Licensures: Certified Coding Specialist (CCS)Preferred Certifications/Licensures: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), AHIMA Approved ICD-10 TrainerGENERAL SKILLS:Organizational SkillsCommunication SkillsInterpersonal SkillsCustomer RelationsMathematicalAnalyticalGrammar / SpellingRead / Comprehend Written InstructionsFollow Verbal InstructionsBasic Computer SkillsMicrosoft Office SuiteGeneral Clerical SkillsPHYSICAL REQUIREMENTS:Have near normal vision - Clarity of vision (both near and far), ability to distinguish colorsAbility to perform - repetitive tasks/motionPHYSICAL DEMANDS:Standing - Occasionally within shift (1-33%)Walking - Occasionally within shift (1-33%)Sitting - Continuously within shift (67-100%)Bending/Stooping - Occasionally within shift (1-33%)Twist at waist - Occasionally within shift (1-33%)Pushing/Pulling - Occasionally within shift (1-33%)Reaching above shoulder - Occasionally within shift (1-33%)Phoebe Putney Health System employees are prohibited from working as Remote employees in the following states:CaliforniaColoradoConnecticutHawaiiMarylandMassachusettsMichiganNevadaNew JerseyNew YorkOregonRhode IslandVermontWashingtonWashington D.C.