Remote HIMS Coding Auditor — DRG & CDI Quality

RIVERSIDE HEALTH INC; Newport News (VA); Hybrid; USD 40,000 - 55,000; Full time

Job summary

Riverside Health System seeks a HIMS Coding Auditor to maintain coded data quality and perform audits of APCs and MSDRGs. Remote work eligible for select states and based in the Newport News area.

Responsibilities include applying coding guidelines, identifying training needs, conducting focused reviews, preparing audit reports, and supporting denial management with payers. Required: CCS, 5–6 years IP/OP coding, 2 years auditing; preferred RHIA/RHIT or CD/CPC credentials.

Qualifications

• 5–6 years Acute Care IP/OP coding experience required.
• 2 years auditing IP/OP coding required.
• 1 year clinical documentation integrity preferred.

Responsibilities

• Maintains coded data quality through ongoing quality review of outpatient or inpatient records.
• Performs audits on accuracy of APC or MSDRGs and on documentation needed for accurate coding.
• Writes appeal letters for DRG/CPT denials and supports denial management.
• Identifies training needs and provides education to team members.
• Prepares audit reports for leadership and assists with internal/external coding audits.
• Assists with coordination of iCare initiatives related to the hospital coding department.

Skills

Coding audits

Data quality

Communication

Team training

Education

High School Diploma or GED

Associates Degree in Healthcare

Tools

Excel

AHIMA guidelines

Denial management tools

Job description

Riverside Health System seeks a HIMS Coding Auditor to maintain coded data quality and perform audits of APCs and MSDRGs. Remote work eligible for select states and based in the Newport News area.

Responsibilities include applying coding guidelines, identifying training needs, conducting focused reviews, preparing audit reports, and supporting denial management with payers. Required: CCS, 5–6 years IP/OP coding, 2 years auditing; preferred RHIA/RHIT or CD/CPC credentials.