Remote Inpatient Coding Quality Auditor

The Ohio State University; United States; Remote; USD 90,000 - 120,000; Full time

Job summary

The Ohio State University is seeking an Inpatient Coding Quality Analyst (Auditor) to validate ICD-10-CM/PCS coding accuracy and DRG/APR-DRG outcomes through targeted and random audits of inpatient records.

The role requires expert knowledge of CMS IPPS, NCCI, and payer-driven edits, along with the ability to educate coding staff and support denial prevention and appeal activities within a large academic medical center setting.

Qualifications

• Associate degree in Health Information Management, Health Information Technology, or related field.
• 3–5 years of inpatient hospital coding experience in an academic medical center or complex acute-care hospital.
• Proficiency in ICD-10-CM and ICD-10-PCS coding, including validation of diagnoses and DRG/APR‑DRG assignment.
• Experience reviewing complex inpatient records for coding accuracy, compliance, and DRG integrity.
• Knowledge of CMS IPPS regulations, OIG, payer audits, DRG validation, and advanced inpatient claim edits.
• Experience using EHRs and health information management systems, including encoder, abstracting, and audit/reporting tools.
• Ability to apply independent judgment in evaluating coding, documentation, compliance risk, and audit findings.
• Strong written and verbal communication, and the ability to educate and collaborate with CDI, Revenue Cycle, Quality, and Compliance.

Responsibilities

• Conduct pre-bill and post-bill audits of high-risk inpatient cases to ensure accurate code assignment and DRG outcomes.
• Document audit results, trends, and recommendations to support continuous quality improvement.
• Resolve complex inpatient claim edits including medical necessity and NCCI considerations.
• Support denial mitigation and appeal activities in collaboration with Revenue Cycle teams.
• Serve as coding quality educator and contribute to guidelines, reference materials, and SOPs.
• Perform 100% pre-bill mortality and targeted audits to support mortality reporting and benchmarking.

Skills

ICD-10-CM/PCS coding

Medical record review

Regulatory/compliance knowledge

EHR systems

Communication skills

Education

Associate degree in Health Information Management

Bachelor’s degree in Health Information Administration

RHIA/RHIT/CCS certification

Tools

Encoder

Abstracting systems

Audit/reporting applications

Job description

The Ohio State University is seeking an Inpatient Coding Quality Analyst (Auditor) to validate ICD-10-CM/PCS coding accuracy and DRG/APR-DRG outcomes through targeted and random audits of inpatient records.

The role requires expert knowledge of CMS IPPS, NCCI, and payer-driven edits, along with the ability to educate coding staff and support denial prevention and appeal activities within a large academic medical center setting.