Hospital Coding Auditor

Ardent Corporate; Brentwood (TN); On-site; USD 80,000 - 110,000; Full time

Job summary

Ardent Health seeks a Hospital Auditor to review inpatient and outpatient records for accuracy, completeness, and regulatory compliance. The role identifies documentation gaps, validates coding accuracy, and strengthens billing integrity to support reimbursement and patient care quality.

The candidate should have 3+ years MS DRG/APR DRG experience, Epic proficiency, and coding certifications (RHIA, RHIT, CCS, CIC, CCDS, CDIP or CPC). Strong communication and analytical skills are essential.

Qualifications

• 3+ years MS DRG/APR DRG experience.
• Epic experience.
• Coding Certification required: RHIA, RHIT, CCS, CIC, CCDS, CDIP or CPC.
• Strong written and oral communication skills; analytical problem-solving.

Responsibilities

• Conduct comprehensive record reviews to identify documentation gaps and process improvements.
• Perform high-level secondary case reviews for accuracy and compliance.
• Assess documentation alignment with ICD-10-CM/PCS, MSDRG/APR-DRG, and payer guidelines.
• Analyze audit findings, identify trends and prepare detailed reports for stakeholders.
• Create and update guidelines and audit procedures to ensure consistency.
• Collaborate with utilization management teams to discuss findings and improvements.
• Deliver education on clinical concepts, documentation, and audit results to clients and staff.
• Perform regular and ad-hoc audits, reviews, and investigations related to data quality and compliance.
• Use CMS guidelines and audit tools to validate findings and trends.
• Present audit outcomes to providers, market leaders, and Compliance Audit Team leadership.
• Manage workload and prioritize tasks to ensure timely audits in line with policies.
• Foster collaboration with internal and external partners and adapt to team needs.

Skills

Communication skills

Analytical thinking

Clinical review judgment

Education

High School Diploma

Tools

Epic

Microsoft Office

Teams/Zoom

Job description

Overview

Ardent Health is a leading provider of healthcare in growing mid‑sized urban communities across the U.S. With a focus on people and investments in innovative services and technologies, Ardent is passionate about making healthcare better and easier to access. Through its subsidiaries, Ardent delivers care through a system of 30 acute care hospitals, 24,000+ team members and more than 280 sites of care with over 1,800 affiliated providers across six states.

POSITION SUMMARY:

The Hospital Auditor is responsible for reviewing hospital (inpatient and outpatient) to ensure accuracy, completeness, and compliance with regulatory guidelines and coding standards. This role supports the team's broader mission by identifying documentation gaps, validating coding accuracy, and assessing the effectiveness of hospital practices. Through targeted feedback and education, the Hospital Auditor helps strengthen documentation quality, promote compliant billing, and safeguard reimbursement integrity, ultimately contributing to improved patient care and organizational compliance.

Responsibilities

1. Conducts comprehensive record reviews to identify documentation gaps and bestpractice process improvement opportunities.
2. Performs highlevel secondary case reviews to ensure accurate, complete, and compliant provider documentation.
3. Assesses documentation alignment with ICD10CM/PCS, MSDRG/APRDRG, and payer guidelines, identifying missed or inappropriate diagnoses, procedures, CC/MCCs, and SOI/ROM opportunities.
4. Analyzes audit findings, evaluate trends and risks, and prepare detailed reports, summaries, and presentations for internal and external stakeholders.
5. Produces, maintains, and updates guidelines, processes, procedures, and documentation standards to support consistent audit practices.
6. Engages with client utilization management teams to provide feedback, clarify findings, and support bestpractice improvement initiatives.
7. Develops and delivers education on clinical concepts, documentation requirements, and audit findings to clients, internal teams, CDI specialists, coders, clinical staff, and product designers.
8. Performs regular and ad hoc audits, reviews, and conducts investigations related to documentation quality, data integrity, and compliance.
9. Utilizes audit tools, authoritative references, CMS/CPT guidelines, and statistical analyses (including bell curves) to identify trends and validate findings.
10. Communicates audit outcomes effectively to providers, market leaders, and Compliance Audit Team leadership.
11. Manages workload, prioritizes tasks, and takes ownership of assignments to ensure timely, highquality audit completion in accordance with policies, procedures, and financial regulations.
12. Supports collaborative relationships with internal and external partners and demonstrate flexibility by working with other team members as needed.

Qualifications

Required Qualifications

• High School Diploma
• 3+ years MS DRG/APR DRG experience
• Epic experience.
• One of the following Coding Certifications required: RHIA, RHIT, CCS, CIC, CCDS, CDIP or CPC
• Expert knowledge of ICD -10-CM coding including but not limited to; expert knowledge of principal diagnosis selection, complications/comorbidities (CCs) and major complications/comorbidities (MCCs), and conditions that impact severity of illness (SOI) and risk of mortality (ROM)
• Expert knowledge of ICD-10-PCS coding methodologies, code sequencing, and discharge disposition in accordance with CMS requirements, Official Guidelines for Coding and Reporting, and Coding Clinic guidance.
• Ability to apply clinical review judgment to make clinical determinations
• Proficient in computer skills and typing, i.e., Microsoft Windows, Outlook, Excel, Word, PowerPoint, Internet browsers and virtual meeting tools i.e., Microsoft Teams, Zoom, etc.
• Strong written and oral communication skills
• Demonstrated analytical approach to problem solving.

Preferred Qualifications

• RN license