Coding Auditor & Educator: Elevate Medical Coding

Brand Allegheny Health Network; United States; On-site; USD 39,000 - 61,000; Full time

Job summary

Allegheny Health Network seeks a Coding Auditor to perform internal, concurrent, prospective and retrospective coding audits. You will review medical records for data quality, ensure accuracy of DRG/APC assignments, and report findings to stakeholders.

The role requires expertise in ICD- CM/PCS, CPT/HCPCS, and regulatory guidelines to drive education and process improvements. You will design coder education programs, monitor external audit findings, and collaborate with compliance teams to

Qualifications

• Minimum: High school diploma / GED
• Certification from AAPC or AHIMA
• 5 years with hospital or physician coding and/or auditing, as well as education techniques and methods
• In-depth knowledge of ICD CM, ICD PCS and CPT/HCPCS coding systems; DRG/APC structure; regulatory guidelines
• Strong analytical and communication skills

Responsibilities

• Plans and conducts audits and reports on documentation, coding and billing at AHN entities.
• Develops and delivers training materials to address deficiencies.
• Provides guidance on external coding audits and education issues.
• Creates audit detail reports and monitors impact on profitability and coding accuracy.
• Validates ICD-CM/ICD-PCS/CPT/HCPCS codes and DRG/APC structures for compliance.
• Mentors staff and participates in coding manager coverage as needed.

Skills

Analytical skills

Communication skills

Education

High school diploma / GED

AAPC or AHIMA certification

Tools

Encoder software

Grouper

Abstracting software

Job description

Allegheny Health Network seeks a Coding Auditor to perform internal, concurrent, prospective and retrospective coding audits. You will review medical records for data quality, ensure accuracy of DRG/APC assignments, and report findings to stakeholders.

The role requires expertise in ICD- CM/PCS, CPT/HCPCS, and regulatory guidelines to drive education and process improvements. You will design coder education programs, monitor external audit findings, and collaborate with compliance teams to