Inpatient Coding Quality Auditor & Educator

University Hospital; Newark (NJ); On-site; USD 98,000 - 142,000; Full time

Benefits offered by this job

Medical & Prescription Drug Coverage

Dental & Vision Insurance

HSA & FSA

Short- & Long-Term Disability

Pension Plan

Employee Assistance Program (EAP)

Professional Development

Job summary

University Hospital in Newark, NJ seeks an Inpatient Coding Data Quality Auditor/Educator to ensure accurate ICD-10 coding, DRG assignment, and compliant documentation. The role leads ongoing education for inpatient coding staff and audits records to optimize reimbursement.

The position requires a BS in health information management, CCS certification, and 3+ years of inpatient coding in a teaching hospital setting with knowledge of CMS/Medi caid guidelines and Epic/Clintegrity tools.

Qualifications

• Requires a bachelor’s degree in health information management or related field.
• CCS certification is required; if not CCS, recertification must be obtained within 60 days of hire or next exam.
• Minimum 3 years of hospital inpatient coding experience with ICD-9/ICD-10 and DRG assignment.

Responsibilities

• Performs daily data quality reviews on inpatient records to validate ICD-10 codes.
• Ensures accuracy and proper sequencing according to coding guidelines.
• Reviews cases for OIG-focused DRGs and transfer DRGs as needed.
• Verifies accuracy and appropriateness of DRG selections.
• Prepares and communicates coding corrections with rationale for education.
• Uses audit tracking tools to identify error types by coder.
• Supports third-party payer documentation to ensure accurate reimbursement.
• Reviews physician queries for timeliness and appropriateness.
• Ensures compliance with CMS, Medicaid, and payer guidelines.
• Monitors coding staff for potential violations and escalates as needed.
• Continuously evaluates clinical documentation quality.
• Identifies incomplete documentation impacting code selection and DRG grouping.

Skills

Attention to detail

Verbal and written communication

Independent work

multitasking and prioritization

Education

Bachelor’s degree in Health Information Management or related field

RHIA or RHIT preferred

CCS certification required

Tools

Clintegrity 360

Epic EHR

Job description

University Hospital in Newark, NJ seeks an Inpatient Coding Data Quality Auditor/Educator to ensure accurate ICD-10 coding, DRG assignment, and compliant documentation. The role leads ongoing education for inpatient coding staff and audits records to optimize reimbursement.

The position requires a BS in health information management, CCS certification, and 3+ years of inpatient coding in a teaching hospital setting with knowledge of CMS/Medi caid guidelines and Epic/Clintegrity tools.