Inpatient Coding Auditor

About the Role

Huron helps its clients drive growth, enhance performance, and sustain leadership in the markets they serve. We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, enabling them to own the future instead of being disrupted by it. Together, we empower clients to create sustainable growth, optimize internal processes, and deliver better consumer outcomes. Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and reduce the cost of providing patient care.

Investing in new partnerships, clinical services and technology is not enough to create meaningful and substantive change. To succeed long-term, healthcare organizations must empower leaders, clinicians, employees, affiliates and communities to build cultures that foster innovation to achieve the best outcomes for patients.

Joining the Huron team means you’ll help our clients evolve and adapt to the rapidly changing healthcare environment and optimize existing business operations, improve clinical outcomes, create a more consumer‑centric healthcare experience, and drive physician, patient and employee engagement across the enterprise.

• Knows, understands, incorporates, and demonstrates Huron’s Vision and Values in behaviors, practices, and decisions.
• Audits inpatient coders and “audit the auditors” to ensure coding accuracy and DRG accuracy of a minimum of 95%.
• Performs quality checks/audits on visits coded as per client SOPs.
• Conducts calibration audits.
• Suggests improvements and schedules calibration sessions with offshore team counterparts and leaders.
• Assists in preparing audit reports, shares direct feedback to coders and auditors on areas of opportunity, and participates in client interactions and internal stakeholder meetings.
• Manages understanding of clinical documentation guidelines.
• Monitors compliance with coding guidelines, identifies errors, initiates corrective action before claims are rebilled.
• Conducts analysis and presents a summary of findings to leadership in a clear, concise, convincing, and actionable format.
• Utilizes encoder software applications and online tools for ICD‑CM, ICD‑PCS, MS‑DRG, APR‑DRG, POA, SOI & ROM assignments.
• Ensures proper capture/reporting of appropriate codes via CDC, CMS, AHA, AHIMA Standards of Ethical Coding, and client coding procedures.
• Navigates patient health records and other computer systems to accurately determine diagnosis and procedure codes, MS‑DRGs, APR‑DRGs, and identify HACs and PSIs that could impact quality data and hospital reimbursement.
• Reviews inpatient health record documentation to assess the presence of clinical evidence supporting diagnosis codes and DRG assignments to potentially decrease denials.
• Maintains professional and ethical standards and updates knowledge by participating in coding team meetings and educational conferences.
• Maintains CEUs as required for coding credentials.
• Stays current with changes in inpatient reimbursement guidelines and regulations, as well as new applications (e.g., Hospital at Home).
• Ensures patient information is correct and signatures are on all medical records.
• Demonstrates knowledge of current coder query practices when consulting with physicians, CDS or other healthcare providers.
• Maintains a working knowledge of applicable coding and reimbursement laws, Code of Ethics, and other policies and procedures.
• Performs other duties as assigned.

• Current permanent United States Work Authorization.
• Working in the United States Day shift schedule.
• 2+ years previous experience as an inpatient coding auditor.
• 3+ years previous experience in coding inpatient hospital accounts.
• Advanced proficiency with Microsoft Office…