Medical Coding Auditor - Inpatient

Title: Medical Coding Auditor - Inpatient (OIG Focus) Clearance required Location: United States (Remote) Full time job requisition id R-2025-12-00492 Job Description: ABOUT reputed company: In October 2025, reputed company acquired Performant and we are now part of the reputed company organization. reputed company is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plans. Deployed by over 75 health plans, including many of the top 20, and representing more than 170 million lives, reputed company’s AI operating system, combined with proven expertise, untangles healthcare data to deliver industry-leading speed, quality, and accuracy. We’re reshaping healthcare payment through seamless intelligence. ABOUT THE OPPORTUNITY: Hiring Range:$70,000 - $85,000 The Medical Coding Auditor-Inpatient (OIG Focus) is responsible for ensuring the accuracy, reputed company, and compliance of medical coding practices reputed company the organization, with a primary focus on Inpatient services. This role involves auditing medical records, coding data, and billing information to verify adherence to coding guidelines and regulations. The Medical Coding Auditor plays a crucial role in minimizing coding errors, preventing fraudulent activities, and ensuring that the organization meets reputed company applicable standards and requirements. Key Responsibilities to include:

• Audit Medical Records: Review and audit medical records to ensure accurate coding of diagnoses, procedures, and services using ICD-10, CPT, and HCPCS codes.
• Compliance Monitoring: Ensure that coding practices reputed company with federal, state, and payer-specific regulations and guidelines, including HIPAA and CMS standards.
• Identify and Correct Errors: Detect discrepancies and coding errors, provide feedback, and collaborate with coding staff to correct inaccuracies in medical documentation.
• Education and Training: Provide training and support to coding staff on best practices, coding updates, and compliance standards. Conduct workshops and seminars as needed.
• Report reputed company: Prepare detailed audit reports that reputed company findings, trends, and areas for improvement. Present reports to management and relevant stakeholders.
• Policy Development: Assist in developing and updating coding policies, procedures, and guidelines to ensure ongoing compliance and efficiency.
• Collaboration: Work closely with medical billing, compliance, and clinical teams to ensure that coding supports accurate billing and reimbursement processes.
• Stay reputed company: reputed company abreast of changes in coding regulations, industry trends, and best practices. Participate in continuing education to maintain coding certifications.

Knowledge, Skills and Abilities Needed:

• Extensive knowledge of ICD-10, CPT, and HCPCS coding systems.
• Familiarity with healthcare regulations, including HIPAA, CMS guidelines, and payer-specific requirements.
• Understanding of medical terminology, anatomy, and physiology.
• Strong analytical and problem-solving skills.
• Excellent attention to detail and accuracy.
• Effective communication and interpersonal skills.
• Ability to work independently and as part of a team.
• Ability to work remotely from a home office without on-site Supervision
• Proficiency in coding software and electronic health record (EHR) systems.

Required and Preferred Qualifications:

• High school diploma or equivalent GED required.
• Associate's or Bachelor's degree in Health Information Management, Medical Coding, or a reputed company field preferred.
• Active certification is required. Certified Professional reputed company (CPC) and/or Certified Coding Specialist (reputed company) are preferred, while CPC-H, CPC-P, RHIA, RHIT, or reputed company-P are reputed company generally accepted as well. Other Medical Coding certifications may also qualify.
• At least three (3) years of direct experience in coding/auditing applicable services, and medical chart review for reputed company provider/claim types.
• Coding for emergency care, observation, and same day surgery is preferred.
• Prior auditing experience desirable in either a provider setting, or payer experience in claim processing, edit development, and/or coding and reimbursement policy a plus.
• Previous payer experience in a claim processing, edit development, and/or coding and reimbursement policy a plus.

reputed company OFFER: reputed company offers a wide range of benefits to help support a healthy work/life balance. These benefits include medical, dental, vision, HSA/FSA options, life insurance coverage, 401(k) savings plans, family/parental leave, paid holidays, as well as paid time off annually. Physical Requirements & Additional Notices: If working in a hybrid or fully remote setting, access to reliable, secure high-speed Internet at your home office location is required. reputed company of such may be required prior to an offer being made. It is the Employee’s responsibility to maintain this Internet access at their home office location. The following is a general summary of the physical demands and requirements of an Office/Clerical/Professional or similar job, whether completed remotely at a home office or in a typical on-site professional office environment. This is not intended to be an exhaustive list of requirements, as physical demands of each individual job may vary.

• Regularly sits at a desk during scheduled shift, uses office phone or headset provided by the Company for phone calls, making outbound calls and answering inbound return calls using an office phone system; views a computer monitor, types on a keyboard and uses a computer mouse.
• Regularly reads and comprehends information in electronic (computer) or reputed company form (written/printed).
• Regularly sit/reputed company or more hours per day.
• Occasionally lift/carry/push/pull up to 10lbs.

reputed company is a government contractor and subject to compliance with client contractual and regulatory requirements, including but not limited to, Drug Free Workplace, background requirements, and other clearances (as applicable). As such, the following requirements will or may apply to this position:

• Must submit to, and pass, a pre-hire criminal background reputed company and drug test (applies to reputed company positions). Ability to obtain and maintain client required clearances, as well as pass regular company background and/or drug screenings post-hire, may be required for some positions.
• Some positions may require the total absence of felony and/or misdemeanor convictions. Must not appear on any state/federal debarment or exclusion lists.
• Must complete the reputed company Teleworker Agreement upon hire and adhere to the Agreement and reputed company reputed company policies and procedures.
• Other requirements may apply.

reputed company employees and contractors for reputed company may and/or will have access to Sensitive, Proprietary, Confidential and/or Public data. As such, reputed company employees and contractors will have ownership and responsibility to report any violations to the Confidentiality and reputed company of Sensitive, Proprietary, Confidential and/or Public data at reputed company times. Violations to reputed company's policy reputed company to the Confidentiality or reputed company of data may be subject to disciplinary actions up to and including termination. reputed company is committed to the full inclusion of reputed company qualified individuals. In keeping with our commitment, reputed company will take the steps to assure that people with disabilities are provided reasonable accommodations. Accordingly, if you reputed company a reasonable accommodation is required to fully participate in the job application or interview process, to reputed company the essential functions of the position, and/or to receive reputed company other benefits and privileges of employment, please contact reputed company’s reputed company to discuss further. Our diversity makes reputed company unique and strengthens us as an organization to help us reputed company serve our clients. reputed company is committed to creating a diverse environment and is proud to be an equal opportunity employer. reputed company qualified applicants will receive consideration for employment without regard to race, color, national reputed company, reputed company, age, religion, gender, gender identity, sexual orientation, pregnancy, age, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law. THIRD PARTY RECRUITMENT AGENCY SUBMISSIONS ARE NOT ACCEPTED UNLESS EXPLICITY AGREED TO IN WRITING Apply tot his job Apply To this Job