The Inpatient QA Coder Auditor is responsible for reviewing and auditing inpatient medical coding for accuracy, compliance, and adherence to regulatory and client-specific guidelines. This role ensures high-quality coding standards, identifies gaps, and provides actionable feedback to coders to drive continuous improvement and coding integrity.
Key Responsibilities
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Perform quality audits on inpatient coding (ICD-10-CM/PCS) to ensure accuracy and compliance with official coding guidelines
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Review medical records and validate appropriate assignment of diagnoses and procedures
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Identify coding errors, trends, and opportunities for process improvement
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Provide detailed feedback, coaching, and education to coders based on audit findings
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Ensure compliance with client requirements, regulatory standards (CMS, AHIMA, AAPC), and internal quality benchmarks
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Maintain audit reports, scorecards, and documentation of findings
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Participate in calibration sessions and client reviews as needed
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Support process improvement initiatives to enhance coding quality and productivity
Qualifications
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Bachelor’s degree in Nursing
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Active coding certification (e.g., CCS, CPC, CIC) with valid credentials
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Minimum 5 years of inpatient medical coding experience
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At least 1–2 years of QA auditing experience in inpatient coding (preferred)
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Strong knowledge of ICD-10-CM/PCS coding guidelines and DRG assignment
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Experience with coding tools such as Epic, Cerner, 3M Encoder, Meditech
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Strong analytical skills with keen attention to detail
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Excellent communication and coaching skills