[Hiring] Inpatient Coding Quality Analyst @The Ohio State University

Role Description

The Inpatient Coding Quality Analyst serves as a subject matter expert responsible for validating the accuracy, completeness, and compliance of ICD‑10‑CM/PCS coding and MS‑DRG/APR‑DRG assignment through both random and targeted audits of inpatient medical records. This position plays a critical role in supporting organizational goals related to regulatory compliance, reimbursement integrity, data quality, audit readiness, and institutional quality performance.

• Independently evaluates complex clinical documentation and coding scenarios.
• Resolves inpatient claim and coding edits.
• Supports denial prevention and appeal activities.
• Collaborates with Revenue Cycle, Central Business Office (CBO), CDI, Compliance, Internal Audit, and clinical stakeholders.
• Supports proactive identification and mitigation of DRG downgrade risk through targeted pre‑bill review, trend analysis, and feedback to coding leadership and CDI partners.
• Provides actionable recommendations to improve coding accuracy, compliance, education strategy, and operational workflows.

Qualifications

• Associate degree in Health Information Management, Health Information Technology, or a related field.
• Minimum of 3–5 years of recent inpatient hospital coding experience in an academic medical center or complex acute‑care hospital setting.
• Demonstrated proficiency in ICD‑10‑CM and ICD‑10‑PCS coding.
• Experience reviewing complex inpatient medical records for coding accuracy, compliance, and DRG integrity.
• Working knowledge of CMS IPPS regulations, OIG compliance expectations, payer audits, DRG validation, and advanced inpatient claim edit frameworks.
• Experience using electronic health records (EHRs) and health information management systems.
• Strong written and verbal communication skills.

Requirements

• Ability to apply independent judgment in evaluating coding, documentation, compliance risk, and audit findings.
• Certification required: Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), or Certified Coding Specialist (CCS) – AHIMA.
• Maintain required continuing education credits (CEUs) in accordance with AHIMA credential standards.
• Participate in required coding, quality, audit, and departmental meetings.
• Complete all mandatory health system training and hospital‑based learning modules (CBLs) in a timely manner.
• Maintain current knowledge of inpatient coding guidelines, regulatory updates, and compliance initiatives.

Benefits

• Remote position.
• Regular position type with scheduled hours of 40.
• First shift hours.