Hybrid Coding Compliance Auditor - MS-DRG Focus

County of Riverside; Riverside (CA); Hybrid; USD 90,000 - 130,000; Full time

Job summary

Riverside University Health System (RUHS) seeks two skilled Coding Compliance Auditors (Administrative Services Manager I) to support the Health System's Compliance Department at Riverside. Responsibilities include conducting reviews of medical records to ensure coding accuracy and delivering feedback to coders and physicians.

These roles involve annual, periodic, and focused audits across inpatient and outpatient coding, collaboration with RAC stakeholders, and developing training programs to

Qualifications

• Bachelor's degree or higher in accounting, business, public administration, information services, finance, or related field.
• Minimum three years in an administrative or staff role with two years supervisory experience across program evaluation, budgeting, or workflow analysis.
• Certifications: CCS, CPC, RHIT/RHIA, CDIP, or CPMA are required.

Responsibilities

• Conduct comprehensive medical record audits for ICD-10-CM/PCS, CPT, and HCPCS coding.
• Evaluate DRG assignment accuracy and validate diagnoses, procedures, and POA indicators.
• Collaborate with CDI, HIM, Revenue Cycle, and Compliance teams to resolve coding discrepancies.

Skills

Coding audits

Regulatory knowledge

Education coordination

Education

Bachelor's degree in accounting, business or public administration, information services, finance, or related field

Tools

3M

Optum

EPIC

Job description

Riverside University Health System (RUHS) seeks two skilled Coding Compliance Auditors (Administrative Services Manager I) to support the Health System's Compliance Department at Riverside. Responsibilities include conducting reviews of medical records to ensure coding accuracy and delivering feedback to coders and physicians.

These roles involve annual, periodic, and focused audits across inpatient and outpatient coding, collaboration with RAC stakeholders, and developing training programs to