Senior Health Information Management Inpatient Coding Auditor

Prisma Health

. Lead coding teams . Train and mentor coders on correct ICD-CM and ICD-PCS guideline application . Manage work queues daily, prioritizing and assigning inpatient accounts for coding within designated timelines . Conduct

Posted 9/29/2026full-timeRemote • South Carolina • United StatesSeniorWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in inpatient coding, including ICD-CM and ICD-PCS guidelines, while effectively leading and mentoring coding teams. Proficient in conducting audits, managing coding compliance, and developing educational programs for clinical documentation and coding practices.

Highest-signal resume keywords

Inpatient Coding ExperienceICD-CM and ICD-PCS GuidelinesRegistered Health Information Technician (RHIT)Certified Coding Specialist (CCS)Clinical Documentation Improvement Principles

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

ICD and ICD-PCS CodingDRG AssignmentCoding AuditsHealthcare Billing ProcessMedical TerminologyBasic Anatomy and PhysiologyPathophysiologyPharmacologyMS DRG Prospective Payment SystemAnalytical Ability

Soft Skills

LeadershipMentoringEffective CommunicationIndependent WorkTime Management

Tools & Technologies

Electronic Medical Records3M SystemEncoder SystemSpreadsheetsDatabases

Certifications & Qualifications

Registered Health Information Administrator (RHIA)Certified Inpatient Coder (CIC)

Industry Keywords

Clinical Documentation IntegrityQuality IndicatorsCoding ComplianceHAC/PSICC/MCC Capture

About the role

Key responsibilities & impact

Lead coding teams
Train and mentor coders on correct ICD-CM and ICD-PCS guideline application
Manage work queues daily, prioritizing and assigning inpatient accounts for coding within designated timelines
Conduct prebill and retrospective audits of discharged inpatient records to validate coding and DRG assignments
Document audit findings to improve CC/MCC capture, risk variable capture, HAC/PSI, HCC, and quality indicator validation
Identify documentation, coding, reimbursement, and coding compliance issues and report trends to coding leadership
Coordinate provider documentation queries for the Clinical Documentation Integrity team
Consult and collaborate with clinical documentation specialists on coding and documentation practices
Develop and maintain coding curriculum and training materials
Develop educational programs for coding, clinical documentation, and medical staff, including yearly coding/DRG updates
Assign ICD and ICD-PCS codes and DRGs for inpatient records, including major traumas and NICU records
Verify DRGs, MCCs/CCs, HACs, and PSIs; select principal diagnoses and assign POA indicators and risk-adjustment diagnoses
Review and respond to inpatient denials and assist with coding and clinical validation denials
Assist management with coding issue resolution, process improvement, and HIM application system testing
Participate in CDI-Coding Task Force and collaborative training with CDI, PFS, specialty areas, and Quality
Perform other duties as assigned

Requirements

What you’ll need

Associate degree or Coding Certificate through an approved American Health Information Management (AHIMA) or other coding certification program
Four (4) years of experience in inpatient coding and abstracting with healthcare billing process in an acute care setting
Required credential: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS), Certified Inpatient Coder (CIC) or other approved coding credential
Knowledge of electronic medical records and 3M or Encoder System
Knowledge of medical terminology, basic anatomy and physiology, pathophysiology, and pharmacology, with ability to apply this knowledge to coding
Knowledge of MS DRG prospective payment system and severity systems
Knowledge of clinical documentation improvement principles, quality indicators, and formal and informal coding audit processes
Ability to work effectively and independently and manage multiple demands consistently
Proficient computer skills, including spreadsheets and databases
Ability to apply broad guidelines to specific coding situations independently, using discretion and significant analytical ability

Benefits

Comp & perks

Full-time employment
Day shift
Remote work indicated in the job title
Participation in on-site, remote and/or external training workshops and training