Clinical Coding Auditor & Trainer jobs in United States
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Veracity Software Pvt. Ltd. ยท 2 months ago

Clinical Coding Auditor & Trainer

Veracity Software Pvt. Ltd. is seeking a Clinical Coding Auditor & Trainer responsible for conducting clinical documentation and coding audits. This role focuses on ensuring compliance with regulations, providing training to clinical and coding teams, and evaluating coding practices for accuracy and quality.

Information Technology & Services

Responsibilities

Conduct DRG validation and inpatient coding audits to ensure medical record accuracy and compliance
Provide training and education to clinical, coding, and quality staff on coding guidelines, audit findings, and process improvements
Review clinical documentation and coding practices for adherence to federal and payer standards (CMS, AHIMA, AAPC, etc.)
Evaluate and recommend process improvements to enhance coding accuracy and quality of medical record documentation
Collaborate with compliance, reimbursement, and medical review teams to ensure audit consistency and alignment
Prepare detailed audit reports summarizing findings, trends, and recommendations for corrective action
Review patient correspondence and letters for grammatical accuracy and clarity
Stay updated on current coding guidelines, industry regulations, and DRG reimbursement models
Participate in special projects, audit planning, and workflow optimization initiatives

Qualification

DRG validationMedical record auditingCPCCIC certificationClinical experienceAnalytical abilitiesCoding training experienceWritten communication skillsVerbal communication skillsAttention to detail

Required

Licensure: RN, PA, MD, APRN, DO, or MBBS license (valid and active)
Education: Associate's degree in Nursing or equivalent healthcare education/experience
Experience: Minimum 4+ years of DRG and/or medical record audit experience
Experience: At least 1 year of clinical experience in a hospital setting
Certifications: Valid/Current CPC or CIC certification (AAPC preferred) or CCS certification (AHIMA)
Strong written and verbal communication skills, including English grammar proficiency
Ability to work independently, manage audit deadlines, and communicate audit findings clearly
Must be willing to travel to New York twice per year for meetings or training

Preferred

Experience in inpatient coding within hospital or managed care environments
RHIA/RHIT credentials preferred
Prior experience providing coding training or audit education
Familiarity with managed care processes, utilization review, or healthcare compliance
Strong attention to detail and analytical abilities

Company

Veracity Software Pvt. Ltd.

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At Veracity, if you have an idea you want to validate, a product you need to build, or an existing product that needs optimization, our teams are trained to jump in wherever needed.

Funding

Current Stage
Growth Stage
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