Coding Auditor & Education Advisor (Remote)

Phoebe Putney Health Systems, Inc.; Georgia; Hybrid; USD 65,000 - 95,000; Full time

Job summary

Phoebe Putney Health System is seeking an experienced Acute Inpatient Coding Auditor with recent acute care hospital experience. This remote Georgia-based role audits facility-based inpatient coding, DRG assignment, and ICD-10-CM/PCS coding accuracy to ensure compliant coding and billing practices.

Responsibilities include educating physicians and staff, querying for documentation gaps, and supporting training for coders.

Qualifications

• 4 year / Bachelor's Degree in Health Information Management or related medical degree required.
• 4–5 years' experience with ICD-9, ICD-10, and HCPCS coding for hospital inpatient records.
• CCS certification required; RHIT/RHIA or AHIMA ICD-10 Trainer preferred.
• Knowledge of MS-DRG, DRG, APC and payer reimbursement methodologies.
• Strong knowledge of Official Coding Guidelines for Coding and Reporting.

Responsibilities

• Audit medical record documentation and coding to assign ICD-10-CM/PCS and HCPCS codes for billing and reporting.
• Educate physicians and staff to ensure complete and accurate coding.
• Query physicians to resolve incomplete or conflicting information.
• Research audit results and resolve denials through appeals and training.

Education

Bachelor's Degree in Health Information Management

Associate Degree plus 4+ years experience

Job description

Job Number: 30780 Location: Remote - Georgia Street Address: Remote Address City, State: Remote, Georgia Zip Code: 31701 Department: PPHS HEALTH INFORMATION MANAGEMENT Shift: First Shift Job Type: Full time Posted Date: 2025-01-21

Job 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 guidelines
• Performs all job responsibilities in alignment with the core values, mission and vision of the organization
• Performs other duties as required and completes all job functions as per departmental policies and procedures
• Maintains 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 overtime

EDUCATION 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 (Required 4 - 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 Trainer

General Skills

• Organizational Skills
• Communication Skills
• Interpersonal Skills
• Customer Relations
• Mathematical
• Analytical
• Grammar / Spelling
• Read / Comprehend Written Instructions
• Follow Verbal Instructions
• Basic Computer Skills
• Microsoft Office Suite
• General Clerical Skills

PHYSICAL REQUIREMENTS: Have near normal vision - Clarity of vision (both near and far), ability to distinguish colors Ability to perform - repetitive tasks/motion

Physical 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:

• California
• Colorado
• Connecticut
• Hawaii
• Maryland
• Massachusetts
• Michigan
• Nevada
• New Jersey
• New York
• Oregon
• Rhode Island
• Vermont
• Washington
• Washington D.C.

All Career Site links will be transferred to new URLs on January 31st, increasing performance and enhancing security. Your application data will be saved, but any bookmarked links will need to be replaced. All candidates with active applications will receive a notification with the new link once the URLs are live.

Thank you for your patience!

Phoebe Putney Health System is southwest Georgia's preferred career choice for professionals who want to improve the community's health by joining a respected, cutting-edge team. We offer you the opportunity to collaborate with the best colleagues in a friendly, close-knit setting that feels like family. Your career at Phoebe will allow you to apply learned skills, explore new paths and advance into greater opportunities. There's more for you at Phoebe. Phoebe is simply the best, most advanced healthcare provider in the region. If you want to work in the medical field, we are the preferred choice, with the best technology, the most specialists and the area's top talent. If you are searching for a non-clinical career that allows you to serve the community and grow, you'll also find us ideal. We're one of the area's premier employers, offering a close-knit culture, outstanding benefits and many ways to develop your career.