Manager of Inpatient Coding Auditing & Education

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Job Title:

Department:

Remote Position

Scope of Position

The Associate Director, Inpatient Auditing & Education is responsible for enterprise oversight of inpatient coding audit operations, audit governance, audit-driven education, and inpatient edit oversight, including National Correct Coding Initiative (NCCI) and Quadax edits. This role provides direct leadership to inpatient coding auditors, coding educators, and coding quality consultants, ensuring consistent, defensible audit methodology and alignment between audit findings, education, and sustained performance improvement.

The Associate Director is accountable for standardizing inpatient audit practices; validating audit accuracy through formal audit-the-auditor processes; and overseeing audit-driven onboarding, competency validation, and remediation frameworks. The role ensures inpatient coding practices support regulatory compliance, payer denial prevention, DRG accuracy, and alignment with organizational quality and public reporting priorities, including Vizient and U.S. News & World Report.

This position works in close collaboration with Clinical Documentation Integrity (CDI), Physician Advisors, Quality, Compliance, Revenue Cycle, and Appeals to mitigate organizational risk, reduce DRG downgrades, and support accurate, risk-adjusted representation of patient severity and outcomes.

The Associate Director executes operational strategy under the direction of the Director of Inpatient Coding and Compliance and does not hold final authority for policy approval or executive escalation decisions.

Position Summary

The Associate Director, Inpatient Auditing & Education provides leadership for inpatient coding audits and audit-informed education within a large academic medical center, with a strong emphasis on OIG and CMS compliance, payer denial prevention, coding quality, and hospital quality outcomes.

This role serves as the operational owner of inpatient audit execution and edit governance, including oversight of NCCI and Quadax edits, ensuring audit and edit outcomes are accurate, consistent, and defensible. The Associate Director translates audit findings, DRG validation trends, denial patterns, and regulatory requirements into targeted education, remediation strategies, and sustained improvements in coding accuracy and documentation integrity.

The position plays a critical role in identifying and mitigating compliance risk, preventing DRG downgrades, and improving performance across key quality metrics, including Hospital-Acquired Conditions (HACs), Patient Safety Indicators (PSIs), mortality indexing, and benchmarking programs such as Vizient and U.S. News & World Report.

Through close collaboration with CDI, Quality leadership, and Physician Advisors, the Associate Director ensures alignment in documentation expectations, coding guidance, and audit standards—supporting ethical coding practices, interdisciplinary consistency, and enterprise-wide risk reduction.

Minimum Qualifications

For Hire:

• Bachelor’s degree in Health Information Management, Nursing, or related field required (Master’s preferred)
• RHIA, RHIT, CCS required
• CCDS or CDIP preferred
• Minimum of 7 years of progressive experience in inpatient coding, CDI, auditing, or compliance in an acute care setting
  • Advanced or extensive experience (10+ years) preferred
  • Experience in a complex healthcare system or academic medical center strongly preferred
• Demonstrated leadership experience required, including leading complex audit, education, or compliance initiatives across multidisciplinary teams; prior direct people management experience preferred
• Advanced knowledge of MS-DRG/APR-DRG methodologies, ICD-10-CM/PCS guidelines, and inpatient coding compliance
• Experience in several of the following areas:
  • Regulatory compliance (CMS, OIG, payer audit focus areas)
  • Denial prevention and appeals support
  • Coding edits (e.g., NCCI, claim edit platforms such as Quadax)
  • Audit program development and quality assurance
  • Clinical validation and DRG downgrade risk
  • Quality metrics (PSI, HAC, Vizient, U.S. News & World Report, etc.)
• Proven ability to:
  • Lead audit and education programs and drive measurable performance improvement
  • Translate complex audit, regulatory, and denial trends into actionable strategies
  • Collaborate effectively across multidisciplinary teams (Coding, CDI, Quality, Compliance, Revenue Cycle, Physician Advisors)
• Equivalent combinations of education and experience demonstrating progressive leadership in inpatient coding, auditing, compliance, or CDI will be considered

On Going:

Maintain required professional credentials and complete ongoing continuing education to remain current with coding, regulatory, and compliance standards.

Additional Information:

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