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Inpatient and Facility Coding Auditor, Claims Review Specialist
CorroHealth. Serve as a revenue cycle and coding consultant, partnering with the Director of HIM .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in revenue cycle management, coding compliance, and auditing practices, with a strong focus on ICD-10, CPT, and HCPCS coding standards. Capable of delivering clear communication and education to clients while maintaining high accuracy and ethical standards in coding.
Highest-signal resume keywords
AHIMA CredentialICD-10-CM/PCS ProficiencyAuditing ExperienceEHR Systems KnowledgeAnalytical Skills
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Coding ComplianceAudit Best PracticesRegulatory ComplianceReimbursement MethodologiesCoding EducationData AnalysisReport PreparationQuality AssuranceDocumentation ComplianceCoding Accuracy
Soft Skills
Communication SkillsProblem-Solving SkillsOrganizational SkillsTeam CollaborationAttention to Detail
Tools & Technologies
Electronic Health Record SystemsMicrosoft Office ApplicationsAuditing SoftwareProprietary Software
Certifications & Qualifications
AHIMA CredentialAAPC CredentialCCSCPCRHIT
Industry Keywords
Healthcare ConsultingInpatient ServicesFacility ServicesCompliance StandardsCoding GuidelinesPatient ConfidentialityAudit FindingsClient EngagementsProductivity StandardsContinuing Education
About the role
Key responsibilities & impact- Serve as a revenue cycle and coding consultant, partnering with the Director of HIM
- Perform complex concurrent and retrospective audits of hospital inpatient, facility, and outpatient claims
- Evaluate coding accuracy and documentation compliance by validating ICD-10, CPT, and HCPCS code assignments in accordance with CMS, AHIMA, AHA Coding Clinic, and official coding guidelines
- Analyze claim and coding data using proprietary software
- Identify opportunities for coding, billing, and revenue cycle improvement
- Develop standardized reports and communicate audit findings to clients
- Provide coding education and answer client questions
- Prepare written guidance and FAQs
- Support client meetings
- Collaborate with the revenue cycle consulting team to drive compliance, operational excellence, and reimbursement optimization
- Analyze findings and identify potential root causes of errors
- Prepare summary reports with specific supporting references
- Provide second-level review of processes and code assignments for compliance
- Research, analyze, and respond to compliance, coding, and denials inquiries
- Protect patient health and client information confidentiality and follow AHIMA Standards of Ethical Coding and official coding guidelines
- Conduct assigned audits while meeting record-type productivity standards and an expected billable productive-hours threshold of at least 80% when client work is available
- Prepare audit deliverables within required timelines
- Conduct independent QA of assigned audit results before final QA review; minimum accuracy expectation of 95%
- Report work time and work products accurately and promptly
- Communicate respectfully with coworkers and promote teamwork and knowledge sharing
- Interact professionally with clients and support company business interests
- Provide management with schedules of planned work activities, events, sites, and changes
- Maintain professional credentials and coding, reimbursement, and compliance knowledge through continuing education
- Travel periodically, as applicable
- Perform other assigned duties
Requirements
What you’ll need- Active AHIMA or AAPC credential required; CCS, CPC or RHIT required
- Minimum of five (5) years of coding and/or auditing experience in an acute care hospital or healthcare consulting environment, including inpatient and facility services
- Strong knowledge of ICD-10-CM/PCS, CPT, HCPCS, reimbursement methodologies, regulatory compliance, and audit best practices
- Proficiency with electronic health record (EHR) systems, such as Epic, Cerner/PowerChart, Meditech, and other healthcare applications
- Advanced analytical, critical-thinking, and problem-solving skills with the ability to interpret complex clinical, coding, and regulatory information
- Strong computer skills, including proficiency in Microsoft Office applications and auditing/reporting software
- Excellent written and verbal communication skills with the ability to present findings and provide clear, client-focused guidance to both operational and executive audiences
- Demonstrated ability to manage multiple projects, client engagements, and priorities while working independently with minimal supervision
- Highly organized with strong attention to detail, accuracy, and commitment to ethical coding and auditing practices
- Experience working remotely and collaborating effectively within a team-oriented, consulting-focused environment
- Ability to work successfully with multiple clients, diverse stakeholders, and cross-functional teams while maintaining productivity and quality standards
- Ability to perform work at a computer terminal for 6-8 hours a day
- Infrequent ability to lift and move material weighing up to 20 lbs.
Benefits
Comp & perks- Quality of life with a remote predictable, full-time schedule
- Medical, Dental, Vision coverage and more
- Long-term disability insurance
- Life insurance
- Ample parental leave
- 401K with company match
- Certification and Tuition Reimbursement
- Holidays
- Flexible Time Off