Acute Hospital Inpatient Compliance Auditor

Company: University of Maryland
Location: Baltimore
Posted on: April 3, 2025

Job Description:

I. General Summary

• Accurately audits hospital Inpatient, Ambulatory Surgery, Observation, and any other outpatient encounter visit for the purpose of appropriate reimbursement, research and compliance with federal and state regulations according to established ICD-10-CM/PCS coding and/or CPT-4 procedure coding classification systems.II. Principal Responsibilities and TasksThe following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job duties performed by personnel so classified.
  • Serves as a clinical coding subject matter expert, and utilizes critical thinking to analyze and evaluate documentation issues with consultation from the medical and clinical staff, and clinical documentation specialists as needed.
  • Audits ICD-10 diagnostic codes and CPT-4 procedure codes to outpatient, ambulatory surgery, and observation visits for the purpose of reimbursement, research and compliance with federal and state regulations.
  • Audits complex inpatient cases such as trauma, rehab, neurology, critical care, etc. utilizing the ICD-10-CM and ICD-10-PCS nomenclature to ensure accurate APR-DRG/SOI/ROM and POA assignment.III. Education and Experience
    • High School graduate or equivalent. Formal ICD-10-CM, ICD-10-PCS, CPT-4 training. Associates or Bachelor's degree. Education will be considered in lieu of experience.
    • Minimum of two years ICD-10-CM/ICD-10-PCS coding and abstracting experience with at a Level 1 Trauma hospital or 4 years of experience with coding inpatient hospital medical records. 2-3 Years Ambulatory coding experience.
    • One of the following: Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Inpatient Coder (CIC)IV. Knowledge, Skills and Abilities
      • Strong analytical and organizational skills; filing systems; ability to prioritize workloads; meet deadlines and work effectively under pressure; excellent customer service skills; general office procedures; ability to problem solve and work with minimal supervision; familiar with basic medical terminology; computer experience; typing ability.Compensation:Pay Range: $36.61-$45.71All your information will be kept confidential according to EEO guidelines.
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Keywords: University of Maryland, Baltimore , Acute Hospital Inpatient Compliance Auditor, Healthcare , Baltimore, Maryland