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Position Title: Inpatient Coding Auditor Department: HIM Coders Job Description: Ask your recruiter about our competitive wages and total rewards package! Remote Eligibility: Candidates must reside and work full-time in AR, KS, MO, OK, or TX before their first day of employment. This position may be filled as levels I, II, or III, depending on individual experience, education, certification(s), and business need. Ideal candidate will have experience in complex inpatient coding at an academic medical center. General Description Ensures accurate, quality, and compliant Inpatient facility coding through prebill and retrospective audits of coder work and providing targeted education to improve consistency and documentation quality. Essential Job Duties Responsibilities listed in this section are core to the position. Inability to perform these responsibilities, with or without an accommodation, may result in disqualification from the position. Performs all functions of coding quality reviews (routine monthly, focus pre-bill, CDI Reconciliations, second-level review work queues) for inpatient coding across OUH. Performs peer-to-peer auditor reviews. Communicate with other teams and departments directly as needed to resolve immediate issues related to account reviews and code/DRG validation. Responds to coding-related questions from internal and external coding staff. Initiates the rebilling process as required per policy on special projects. Trials tip sheets and training developed by auditing team and provide constructive feedback. Maintains or exceeds established productivity and accuracy standards, delivering consistent day to day results that directly support team performance, data integrity, and organizational objectives. Meets all educational requirements as stated in current Company policy. Reviews all official data quality standards, coding guidelines, Company policies and procedures, and clinical/medical resources to assure coding knowledge and skills remain current. General Job Duties Performs other duties as assigned Minimum Requirements (Level 1): Education: High School diploma or GED required. Experience: At least 1 year of Inpatient Facility Coding Auditing or DRG Validation with a minimum of 5 years of experience in Inpatient facility coding required. Certification/License/Registration: RHIA, RHIT, CCS, CPC, or CIC required Minimum Requirements (Level 2): Education: High School diploma or GED required. Experience: At least 3 years of experience in Inpatient Facility Coding Auditing or DRG Validation, including at least 2 years of coding at an Academic Health Center required. Certification/License/Registration: RHIA, RHIT, CCS, CPC, or CIC required Minimum Requirements (Level 3): Education: Associate's degree required. Experience: At least 5 years of experience Inpatient Facility Coding Auditing at an Academic Health Center required. Certification/License/Registration: RHIA, RHIT, CCS, CPC, or CIC required. HFMA CRCR required within 6 months of hire. Current OU Health Employees - Please click HERE to login. OU Health is an equal opportunity employer. We offer a comprehensive benefits package, including PTO, 401(k), medical and dental plans, and many more. We know that a total benefits and compensation package, designed to meet your specific needs both inside and outside of the work environment, create peace of mind for you and your family.

PURPOSE OF THIS POSITION The primary purpose of this position is to manage the overall operations of the professional coding integrity team, including the overall performance of the professional coding program to ensure consistency, accuracy, compliance, optimal reimbursement and reduced denials. The Manger will collaborate with providers and clinical department leadership to support the integrity of the documentation to support the charges entered and the codes assigned. This position reports to the Director of Health Information Services. The Professional Coding Integrity Supervisor, the Professional Coding Auditor and Educator and the Professional Coding Claims Resolution Specialist positions report directly to this position. JOB DUTIES/RESPONSIBILITIES Duty 1: Provide management oversight of the professional coding integrity team and related functions with the primary objective to support the optimal performance of the profee coding program, which includes proper ICD-10 / CPT code assignment to ensure compliance with applicable regulatory standards, maintain high level of quality and consistency, optimize reimbursement, and reduce denials. Effectively communicate and solicit input from team and other impacted areas to promote a collaborative and innovative team environment, translates BVHS's Mission, Vision and Values into front-line action. Duty 2: Perform and/or provide oversight to managerial administrative support functions including but not limited to facilitate the recruiting and hiring process, training & education of associates, monitor appropriate staffing levels, payroll, performance evaluations, recognition and reward, disciplinary follow up as appropriate, establish/monitor performance metrics, monitor completion of organization requirements. Assists Director in developing and monitoring department budget and strives to control departmental costs. Duty 3: Active engagement to support organization cascading goals initiative, including idea boards, associate engagement, service excellence and contribution margin. Duty 4: Recommends and implements professional coding compliance plan and related policies and procedures to promote compliant and consistent coding practices, inclusive of ICD/CPT code assignments which are reflective and supported by clinical documentation. Monitors and modifies plan in anticipation of changing organizational needs (e.g. implement a new service line) and/or in response to revised regulatory requirements (e.g. IPPS and OPPS annual updates, CPT Assistant, Coding Clinic, etc.). Ensure appropriate dissemination of information and education to ensure coding integrity team and/or any other pertinent individuals or departments remain current on coding compliance plan/policies and procedures. Duty 5: Provides oversight of the professional coding integrity quality audit program to ensure the overall accuracy of work performed. Oversees and monitors the results of quality audits performed by Professional Coding Auditor and Educator and supports the resolution of identified opportunities through the creation and implementation of an action plan. Monitors third party payer audits and assists, as necessary, defending takebacks and in the appeal process related to code assignments and evaluate opportunities to reduce coding denials. Ensures relevant decisions related to coding practice are documented in policies or procedures to promote ongoing standardization and consistency. Duty 6: Develop and track key metrics to measure overall performance of team operations. Analyze data to determine opportunities for improvement and implement follow up or action plans to address. Evaluate workflows and processes to address issues that may be causing delays or for opportunities to continue to optimize operational efficiencies. Strive for continuous performance improvement through monitoring industry best practices and evaluating / implementing tools and processes to enhance work performance and outcomes. Duty 7: Collaborate with Corporate Compliance Department in audits or initiatives related to professional coding and charge processes. This may include involving team in coding reviews in response to an investigation or potential compliance risk, conducting charge-related research, assisting to develop an audit tool or interacting with third party consultants conducting a compliance audit. Duty 8: Collaborates and maintains open communication with the medical providers and clinical leadership on coding and documentation practices with a primary focus to maintain compliant practices which accurately reflects reporting of coded data and provider metrics. Foster positive relationships with providers and clinical teams to create a spirit of partnership and alignment of organizational goals. Provide feedback and education to providers / clinical team on opportunities identified. Duty 9: Regularly attend and actively participate in relevant education / conferences, organizational meetings and continuing education programs as offered in order to remain current with organizational and industry changes and best practice. Communicate and disseminate information to other departments as applicable. Provide training and educational support/opportunities to the Revenue Integrity Team. Duty 10: Demonstrate superior understanding of federal, state and third party coding guidelines related to coding practices. Collaborate with Revenue Integrity Department, as needed, to implement revisions to charge/billing regulations, including annual IPPS and OPPS updates. Duty 11: Demonstrates thorough understanding of systems utilized to support operations, including Cerner, 3M Encompass, Craneware, Quadex and workflows and provide support to super users as needed to ensure optimal utilization of systems and operational workflows. REQUIRED QUALIFICATIONS A Bachelor's degree in a related field including but not limited to, Health Information Management (HIM) or 4+ years' experience from which comparable knowledge and abilities have been acquired. CPC certification required or achieved within 9 months of hire date. Medical terminology and Anatomy & Physiology. Knowledge of ICD10/DRG/Coding Clinic, CPT/HCPCS/APC/CPT Assistant/Modifiers. Knowledgeable of revenue cycle workflows, including information and charge workflows throughout the health system. Advanced technical aptitude, mastery of desktop applications including Microsoft Office Suite (Excel, Powerpoint, Word), internet, electronic health records, and encoder. Strong problem solving and analytical skills, ability to manage project tasks and timelines. Self-directed. Must possess positive service-oriented and interpersonal skills; strong communication, including written and verbal presentation skills, required. Ability to manage controversial situations in a professional way and demonstrate sound judgment and reasoning skills. Ability to effectively lead a team incorporating the BVHS's Mission, Vision and Values into the culture. Maintain effective connectivity and collaboration between all members of the team, including onsite and remote associates. A valid driver's license is required (if you do not have a valid Ohio driver's license you must obtain one within 30 days of your residency in the state). You must also meet BVHS's company fleet policy and insurance company requirements, and any other requirements that may be required to operate a vehicle. PREFERRED QUALIFICATIONS Certification in HIM (RHIA or RHIT) Other relevant certifications, including CEMC, CANPC or CPB Knowledge of Clinical Documentation Improvement concepts PHYSICAL DEMANDS This position requires a full range of body motion with intermittent activities in sitting, walking, lifting, bending, squatting, climbing, kneeling, twisting and standing. The associate must be able to lift 50 pounds or more and reach work above the shoulders. The individual must have excellent eye/hand coordination with the ability to grasp, push and pull, fine finger dexterity and manipulation. This position requires corrected vision and hearing in the normal range. The associate must have excellent verbal skills to communicate with patients, physicians, and co-workers.

St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care. The Network Coordinator, Coding Audit & Education performs internal, concurrent, prospective and retrospective coding audit activities. Reviews/validates coded medical records of Professional Coding (PC) staff to determine data quality and accuracy of coding, billing and documentation related to ICD-10, PCS, DRGs.CPT, APC's, and HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding, DRG/APC structure according to regulatory requirements. JOB DUTIES AND RESPONSIBILITIES: Coding audits of Professional Coding staff in accordance with regulatory requirements, official coding guidelines, and Network audit standards. Reviews and validates coded medical records to assess coding accuracy, documentation integrity, compliance risk, and reimbursement impact related to ICD-10-CM/PCS, CPT/HCPCS, DRG/APC assignment, modifiers, and applicable payment methodologies. Analyzes audit results to identify trends, patterns, and areas of risk or opportunity, including recurring errors, documentation gaps, and compliance vulnerabilities across the hospital system. Develops audit summaries, reports, and tracking tools to communicate findings, monitor improvement over time, and support leadership review and decision-making. Provides targeted, audit-driven education and training to Professional Coding staff, including one-on-one feedback and department-level education based on validated audit findings. Collaborates with Coding Management and Compliance to recommend corrective actions, process improvements, and risk mitigation strategies based on audit outcomes. Supports onboarding and ongoing education of coding staff by contributing audit-based insights, educational materials, and coding guidance aligned with official standards and Network expectations. Participates in external audit activities, including preparation, review, validation of findings, and assistance with response development, in collaboration with Coding Management and Compliance. Promotes accurate, compliant documentation and coding practices through consistent application of coding principles, official guidelines, and regulatory requirements. PHYSICAL AND SENSORY REQUIREMENTS: Sitting up to 7 hours per day, 3 hours at a time. Repetitive arm/finger use for retrieving/viewing computerized patient medical records and abstracting information. Extended periods of vision use for reviewing computerized patient records, abstracting of patient information, approximately 7 hours per day, hours at a time. Hearing as it relates to normal conversation. Seeing as it relates to general vision, peripheral vision and visual monotony. Occasionally may be required to use upper extremities to lift up to 10 lbs.; stoop, bend, or reach to retrieve resource materials and/or paper records in accordance with downtime policy; or use wheel cart. EDUCATION: Must maintain and be credentialed in at least ONE of the following AHIMA and/or AAPC recognized Professional Coding Certifications: Registered Health Information Technician (RHIT); Registered Health Information Administrator (RHIA); Certified Professional Auditor (CPMA); Certified Professional Coder (CPC); Certified); Certified Coding Specialist (CCS); In-depth knowledge of ICD CM, ICD PCS and CPT/HCPCS coding systems. Must be proficient in DRG/APC structure, National Correct Coding Initiatives, ICD CM/PCS/CPT Official Guidelines, Outpatient Prospective Payment System and Coding Clinic References. Current working knowledge of encoder/grouper. Strong analytical and communication skills. TRAINING AND EXPERIENCE: 5 years of coding experience required. Experience in auditing education techniques and methods preferred, but not required. Please complete your application using your full legal name and current home address. Be sure to include employment history for the past seven (7) years, including your present employer. Additionally, you are encouraged to upload a current resume, including all work history, education, and/or certifications and licenses, if applicable. It is highly recommended that you create a profile at the conclusion of submitting your first application. Thank you for your interest in St. Luke's St. Luke's University Health Network is an Equal Opportunity Employer.