Coding Auditor-Compliance- Inpatient Auditing - Day

York, PA | Professional | Tracking Code: 104011

Schedule & Location:

Full-Time: 80 hours, biweekly

Monday-Friday: 8am-4:30pm

Remote work opportunity 

Job Description:

Under the general supervision of the Manager – Compliance Risk and Facility Audits, assists in planning the scope, objectives, and approach of audit projects. Completes medical record reviews in pre-identified areas to assess compliance with applicable laws and regulations in key areas of medical necessity, coding sequencing and clinical documentation of billed charges. Prepares and presents written and oral reports summarizing audit work, issues identified and recommendations to management. Assists with the identification and execution of solutions to correct any issues identified. Maintains audit records in compliance with System policy. Educates members of the patient care team on documentation guidelines/solutions identified through the audit activity as directed


Duties and Responsibilities:

  1. Assesses medical record documentation for coding compliance and compliance with applicable laws and regulations in areas such as medical necessity, coding sequencing and clinical documentation in support of billed charges.
  2. Demonstrates knowledge of DRGs, documentation requirements, current coding guidelines and the chart review process.
  3. Documents audit results in the appropriate system as directed.
  4. Prepares written reports pertaining to determinations and recommendations resulting from routine audits and/or assigned special projects. Presents reports to appropriate managers and boards as needed.
  5. Educates internal customers on compliant documentation opportunities and coding and reimbursement issues.
  6. Assists with planning, developing, and recommending objectives, procedures, and systems to be used in auditing entities, functions, and departments throughout the System.
  7. Investigates and recommends action to be taken when control, operational weaknesses and/or compliance issues are found. Monitors implementation of recommended corrective action and performs follow up reviews where necessary.
  8. Assists with compliance program implementation throughout the organization.
  9. Assists with monitoring the Compliance Program.
  10. Assists in the development and dissemination of education and training processes for the employees regarding compliance related activities.
  11. Assists with any investigations in accordance with the investigation protocol established by the organization.
  12. Assists in responding to questions, issues, concerns, and reports of possible misconduct reported or identified through the
  13. organization's hotline or other reporting lines.
  14. Assists with the development and oversight of the implementation of corrective action plans to address noncompliance.
  15. Supports the organization's commitment to comply with all federal, state, and local standards, with an emphasis on
  16. prevention of fraud and abuse.
  17. Promotes and adheres to the Code of Conduct and the elements of the Compliance Program and exercises due diligence to ensure compliance with policies and legal requirements.



  • Minimum Experience:
    • 5 years’ experience in ICD-10 coding with a strong understanding of Medicare’s Inpatient DRG and other PPS methodologies; CPT coding knowledge
    • Must have inpatient coding experience


  • Min Field of Expertise: Health Information Management


  • Minimum Education:
    • Bachelor's Degree


  • Required Certification:
    • Certified Coding Specialist (CCS) or equivalent (or obtain within a year)


  • Skills:
    • A working knowledge of chart review processes and knowledgeable of current Coding Clinic guidance; Knowledge of Federal Regulatory resources; Clinical knowledge and understanding of disease processes and/or ability to research this topic; Ability to interact effectively and professionally with physicians, other health care professionals, managers, executives, and various support staff departments in a poised, non-confrontational manner; Strong organizational skill and detail oriented; Excellent written and verbal communication skills including ability to develop and deliver formal presentations; Proficient with computer systems and in use of MS Office software products; self-motivated with the ability to work under minimum supervision while understanding the importance of being a part of a team.



Nicole Eckert
Talent Acquisition Consultant

WellSpan invests in you!

Join WellSpan, where we invest in our team members:

  • $17 minimum wage starting July 2, 2023
  • Enhanced weekend differential for most hourly employees
  • More than $245M invested in merit increases, rewards and educational support in the past two years
  • Competitive salaries, benefits, paid time off and a commitment to diversity

Join us and make a difference.

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Employment Benefits

  • Sign-on incentives for new employees
  • Medical, dental and vision insurance
  • Life and accidental death insurance
  • Supplemental life insurance
  • Retirement savings plan
  • Paid time off (PTO)
  • PTO bridging
  • Short-term disability
  • Educational assistance
  • Forgivable loan
  • Flexible spending
  • Credit union
  • Employee recreational activities
  • Childcare
  • Complimentary medicine discounts
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Diversity, Equity & Inclusion at WellSpan

WellSpan Health recognizes and honors the diversity of our team members, patients and neighbors, and we embrace all the human characteristics that make us similar and unique. We strive to make every person feel welcomed, respected and valued by creating a safe and inclusive environment to which we all feel a sense of belonging. We are equally committed to ensuring all team members have the opportunity to excel and are positioned for success through equitable policies, practices and resources.

WellSpan Health is an Equal Opportunity Employer. It is the policy and intention of the System to maintain consistent and equal treatment toward applicants and employees of all job classifications without regard to age, sex, race, color, religion, sexual orientation, gender identity, transgender status, national origin, ancestry, veteran status, disability or any other legally protected characteristic. WellSpan Health does, however, have a tobacco-free/nicotine-free hiring policy.

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Quality of Life

Founded in 1741, the city of York is considered by many as the first capital of the United States. The Articles of Confederation were signed by the Second Continental Congress here in 1777. Its beautifully restored historic district is an architectural treasure. While York retains its farming and manufacturing heritage, at its heart York is a thriving cultural community that has attracted creative talent and innovative entrepreneurial investors from across the nation.

Life in York County offers affordable housing, options for higher education, a thriving arts and cultural community, historical attractions, parks and recreational resources, semi-professional baseball team, fine dining and more — within an easy drive of major East Coast cities.

York County residents can find local employment in healthcare, manufacturing, technology, agricultural and service sectors. (Patient population: 445,000)

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