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Medical Review Coding QA Auditor - Inpatient

Remote, USA Full-time Posted 2025-07-27
    Description:
  • The Medical Review Coding QA Auditor (Inpatient) is responsible for conducting Quality Assurance (“QA”) reviews of medical review audit work
  • Communicates and supports the identification of potential training opportunities or enhancements to training and/or concept review guideline materials and tools
  • Responsible for performing some audit activity and consistently achieves or exceeds productivity goals and quality standards
  • Serves as subject matter expert, provides supplemental escalation support, and may perform special project activity as needed
    Requirements:
  • Minimum of a High School Diploma or GED is required
  • Current certification as a CPC, CPC-H, CPC-P, RHIA, RHIT, CCS, or CCS-P
  • 3+ years of (MS/APR) DRG coding for hospital, physician’s office or other acute facility setting preferred
  • 5+ years relevant auditing experience in a provider or payer environment demonstrating breadth and depth of knowledge/skills for the position
  • Prior experience in role with responsibility for conducting primary audit, utilization or prior-authorization work, or quality review of audit work performed by others
  • Prior experience in payer edit development and/or reimbursement policy a plus
  • Prior experience working in remote setting preferred
    Benefits:
  • Medical, dental, vision
  • Disability coverage options
  • Life insurance coverage
  • 401(k) savings plans
  • Paid family/parental leave
  • 11 paid holidays per year
  • Sick time and vacation time off annually

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