Inpatient Coding Quality Analyst (Auditor)

Responsibilities

• Validate accuracy, completeness, and compliance of ICD-10-CM/PCS coding and MS-DRG/APR-DRG assignments
• Conduct random and targeted audits of inpatient medical records
• Resolve inpatient claim and coding edits, including medical necessity and DRG validation
• Support denial prevention and appeal activities
• Perform 100% pre-bill review of inpatient mortality cases
• Provide educational feedback and guidance to inpatient coding staff
• Collaborate with Revenue Cycle, CDI, Compliance, and clinical stakeholders

Requirements

• Associate degree in Health Information Management, Health Information Technology, or a related field
• 3-5 years of recent inpatient hospital coding experience in an academic medical center or complex acute-care setting
• Proficiency in ICD-10-CM and ICD-10-PCS coding
• Working knowledge of CMS IPPS regulations and OIG compliance expectations
• Experience using electronic health records (EHRs) and HIM systems
• One of the following certifications: RHIA, RHIT, or CCS (AHIMA)

Preferred Qualifications

• Bachelor's degree in Health Information Administration or Management
• Experience in inpatient coding quality review, auditing, or denial management
• Experience supporting mortality case review and quality reporting (e.g., Vizient, USNWR)

Benefits

• Medical, dental, and vision coverage
• Paid time off, including sick and vacation time and 11 holidays
• State retirement plan or alternative retirement plan with employer contributions

About the Company

The Ohio State University is a top-20 public university with one of America's leading academic health centers, committed to excellence in education, research, and health care.