Coding Quality Audit Reviewer

HCA Healthcare; Corpus Christi (TX); Remote; USD 50,000 - 90,000; Full time

Job summary

An established industry player is seeking a dedicated Inpatient Coding Quality Auditor to ensure compliance with national coding guidelines and improve data integrity. In this role, you will lead quality reviews and assist in maintaining high standards of accuracy and productivity. Join a team that values your contributions and offers a supportive environment, where your efforts directly impact patient care. With a commitment to investing in your growth, this organization provides a comprehensive benefits package and opportunities for professional development. Make a difference in healthcare today!

Benefits

Comprehensive Medical Coverage

401(k) Plan with Matching

Employee Stock Purchase Plan

Education Assistance

Time Away From Work Program

Employee Health Assistance Fund

Flexible Spending Accounts

Free Counseling Services

Colleague Recognition Program

Qualifications

• 5+ years of acute care inpatient and outpatient coding experience required.
• 3+ years of coding auditing/monitoring experience strongly preferred.

Responsibilities

• Lead and perform quality reviews for inpatient and outpatient coding.
• Ensure adherence to coding guidelines and policies.

Skills

Medical Coding Practices

Quality Assessment Reviews

Data Integrity

Compliance with Coding Guidelines

Education

Undergraduate Degree in HIM/HIT

Associates or Bachelors in Health Information Management

Job description

Description

Introduction

Do you want to join an organization that invests in you as a Coding Quality Audit Reviewer? At Work from Home, you come first. HCA Healthcare has committed up to 300 million in programs to support our incredible team members over the course of three years.

Benefits

Work from Home offers a total rewards package that supports the health, life, career, and retirement of our colleagues. The available plans and programs include:

• Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.
• Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance, and more.
• Free counseling services and resources for emotional, physical, and financial wellbeing.
• 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service).
• Employee Stock Purchase Plan with 10% off HCA Healthcare stock.
• Family support through fertility and family building benefits with Progyny and adoption assistance.
• Referral services for child, elder, and pet care, home and auto repair, event planning, and more.
• Consumer discounts through Abenity and Consumer Discounts.
• Retirement readiness, rollover assistance services, and preferred banking partnerships.
• Education assistance (tuition, student loan, certification support, dependent scholarships).
• Colleague recognition program.
• Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage, and leaves of absence).
• Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.

Learn more about Employee Benefits

Note: Eligibility for benefits may vary by location.

You contribute to our success. Every role has an impact on our patients’ lives, and you have the opportunity to make a difference. We are looking for a dedicated Inpatient Coding Quality Auditor to be a part of our team.

Job Summary and Qualifications

The Inpatient Coding Quality Auditor will be responsible for performing internal quality assessment reviews on Health Information Management Service Center (HSC) coders to ensure compliance with national coding guidelines, HSC coding policies, and company coding policies for complete, accurate, and consistent coding. This ensures appropriate reimbursement and data integrity. The role involves reviewing outcomes to improve accuracy, integrity, and quality of patient data, minimizing variation in coding practices, and enhancing physician documentation to support code assignments.

What you will do in this role:

• Lead, coordinate, and perform all functions of quality reviews (routine, pre-bill, policy-driven, and incentive plan driven) for inpatient and/or outpatient coding across multiple HSCs.
• Assist in ensuring HSC coding staff adherence to coding guidelines and policies.
• Demonstrate and apply expert-level knowledge of medical coding practices and concepts.
• Participate in special reviews or projects.
• Maintain or exceed 95% productivity standards.
• Maintain or exceed 95% accuracy.
• Meet all educational requirements as stated in current company policy.
• Review all official data quality standards, coding guidelines, company policies, procedures, and clinical/medical resources to ensure coding knowledge remains current.

Qualifications Needed:

• Undergraduate degree in HIM/HIT preferred (Associates or Bachelors).
• Minimum of 5 years of acute care inpatient and outpatient coding experience required.
• Minimum of 3 years of coding auditing/monitoring experience strongly preferred.
• RHIA, RHIT, and/or CCS preferred.

Parallon provides full-service revenue cycle management for HCA Healthcare, including scheduling, registration, insurance verification, hospital billing, revenue integrity, collections, payment compliance, credentialing, health information management, customer service, and physician billing. We serve nearly 1,000 hospitals and 3,000 physician practices, impacting patients, providers, and communities.

HCA Healthcare has been recognized as one of the World’s Most Ethical Companies by the Ethisphere Institute more than ten times. We have invested billions in charitable care and uninsured discounts.

"Good people beget good people."
- Dr. Thomas Frist, Sr.
HCA Healthcare Co-Founder

We are a family of 270,000 dedicated professionals. Our Talent Acquisition team is reviewing applications for the Coding Quality Reviewer position. Qualified candidates will be contacted for interviews. Submit your resume today to join our community of caring!

We are an equal opportunity employer. We do not discriminate based on race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.