Inpatient/Outpatient Facility Coding Auditor

PYA; Atlanta (GA); On-site; USD 70,000 - 100,000; Full time

Job summary

PYA is seeking an Inpatient/Outpatient Facility Coding Auditor to join its private, nationally recognized firm. You will support PYA’s Revenue and Compliance Advisory Program and work with hospital clients on coding, audits, DRG validation, and reimbursement strategies.

Ideal candidates have 5+ years inpatient coding auditing experience and credentials such as CCS, RHIA, RHIT or CIC. Strong communication, leadership, and client relationship skills are essential.

Qualifications

• Professional credential required such as CCS, RHIA, RHIT, CIC or other AHIMA or AAPC approved coding credential
• Minimum of 5 years of inpatient coding auditing and reimbursement experience in a hospital setting or with a professional services firm preferred
• Demonstrated expertise in medical terminology, including anatomy and physiology
• Demonstrated expertise in medical coding auditing with knowledge of billing, coding, and documentation practices in inpatient and outpatient hospital settings

Responsibilities

• Apply inpatient and outpatient facility/hospital coding and reimbursement methodologies to provide advisory services to clients
• Code ICD-10-CM and PCS/CPT/HCPCS and validate DRGs
• Perform APC validation and charge capture
• Support clinical documentation improvement and regulatory compliance for third party payors
• Collaborate with the PYA executive team to deliver complete business solutions
• Manage client deliverables with strong project management and risk awareness

Skills

Coding credentials

Leadership/communication

Tools

Microsoft Office Suite

Job description

PYA is seeking an Inpatient/Outpatient Facility Coding Auditor to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will support PYA’s Revenue and Compliance Advisory Program.

RESPONSIBILITIES:

• Apply inpatient and outpatient facility/hospital coding and reimbursement methodologies to provide advisory services to PYA clients with a focus on the following:
• ICD-10-CM and PCS/CPT/HCPCS code assignment
• MS-DRG and other DRG validation
• APC validation and charge capture
• Clinical documentation improvement
• Regulatory compliance for third party payors
• Work in collaboration with the PYA executive team and other service lines to offer complete business solutions to clients
• Manage the preparation of excellent client deliverables and exhibit exceptional project management skills while balancing firm risk and compliance with appropriate professional standards

QUALIFICATIONS:

• Professional credential required such as CCS, RHIA, RHIT, CIC or other AHIMA or AAPC approved coding credential
• Minimum of 5 years of inpatient coding auditing and reimbursement experience in a hospital setting or with a professional services firm preferred
• Previous experience working with a professional services firm preferred
• Demonstrated expertise in medical terminology, including anatomy and physiology
• Demonstrated expertise in medical coding auditing with knowledge of billing, coding, and documentation practices in inpatient and outpatient hospital settings
• Adept knowledge of Microsoft Office Suite
• Excellent written and oral communication skills
• Ability to handle multiple projects
• Exhibits leadership skills supporting the management of PYA staff
• Demonstrated ability to manage client relationships with professionalism, executive presence, and candor
• Alternative bonus: Demonstrated expertise in professional fee coding auditing and credentialed in the same (CPC, CCS-P, etc.)

ABOUT PYA

PYA, a leading independent professional services firm, serves clients across the United States with expertise in consulting, accounting, audit, tax, compliance, and business strategy. With offices in Knoxville, Atlanta, Tampa, Charlotte, Nashville, and Kansas City, PYA is committed to helping clients achieve their goals through innovative solutions and unparalleled service. PYA is also a member of HLB, the global accounting and advisory network, with affiliate firms in over 150 countries. Learn more about The PYA Way.

Why Join PYA?

• Be part of a dynamic and collaborative team that values innovation and excellence
• Work with industry leaders who are committed to professional growth and client success
• Competitive compensation, comprehensive benefits, and opportunities for career advancement