Remote Inpatient Coding Quality Auditor

The Ohio State University Wexner Medical Center; United States; Remote; USD 85,000 - 110,000; Full time

Job summary

The Ohio State University Wexner Medical Center is seeking an Inpatient Coding Quality Analyst to drive coding quality, compliance, and audit readiness for inpatient records. The role focuses on validating ICD-10-CM/PCS coding and MS-DRG/APR-DRG assignments through targeted audits and education across CDI, Revenue Cycle, Compliance, and clinical teams.

Responsibilities include pre- and post-bill audits, DRG integrity validation, and providing expert guidance to coding staff.

Qualifications

• Associate degree in Health Information Management or related field.
• 3–5 years of inpatient hospital coding experience in academic medical center or complex acute-care setting.
• Proficiency in ICD-10-CM and ICD-10-PCS coding with MS-DRG/APR-DRG assignment validation.
• Experience reviewing complex inpatient records for coding accuracy and DRG integrity.
• Knowledge of CMS IPPS regulations, OIG expectations, payer audits, and DRG validation.
• Experience using EHRs and coder/abstracting/audit software; ability to communicate findings clearly.

Responsibilities

• Conduct pre-bill and post-bill audits to ensure accurate code assignment and DRG/APR-DRG outcomes.
• Provide education and guidance to inpatient coding staff; contribute to coding guidelines and SOPs.
• Collaborate with Revenue Cycle, CDI, Compliance, Internal Audit, and clinical stakeholders.
• Identify and mitigate mortality and high-risk DRG downgrade risks; support quality reporting.
• support denial mitigation and appeals; validate failed or rejected inpatient claims.

Skills

ICD-10-CM coding

ICD-10-PCS coding

DRG validation

CMS IPPS regulations

Auditing & chart review

EHR systems

Communications

Education

Associate degree in HIM / Health Information Technology

Bachelor's degree in HIM (preferred)

RHIA / RHIT / CCS certification (preferred)

Tools

Encoder software

Abstracting systems

Audit/reporting applications

Job description

The Ohio State University Wexner Medical Center is seeking an Inpatient Coding Quality Analyst to drive coding quality, compliance, and audit readiness for inpatient records. The role focuses on validating ICD-10-CM/PCS coding and MS-DRG/APR-DRG assignments through targeted audits and education across CDI, Revenue Cycle, Compliance, and clinical teams.

Responsibilities include pre- and post-bill audits, DRG integrity validation, and providing expert guidance to coding staff.