Clinical Coding Auditor RN
Location: Centene, NY
Job Type: Direct Placement
Company: ARC Group
Category: Administration
Job Description Apply Now
If you are seeking a meaningful opportunity to make a significant impact in healthcare, consider joining our team as a Clinical Coding Auditor RN. This pivotal role is ideal for professionals with a strong background in nursing and clinical coding who are ready to utilize their expertise in auditing and training within a dynamic managed care environment. As a Clinical Coding Auditor RN, you will play a key part in ensuring the accuracy and compliance of inpatient coding processes, while also educating and supporting colleagues to enhance operational excellence and patient outcomes.
With a focus on continuous improvement, the Clinical Coding Auditor RN will develop and deliver comprehensive training programs, conduct detailed audits, and collaborate with a dedicated team to maintain the highest standards of clinical coding. The position offers a flexible, primarily remote work setting with a minimal travel requirement, allowing you to balance personal and professional growth while contributing to a mission-driven organization.
Our organization is committed to transforming the health of our communities by providing exceptional care and innovative solutions. We value diversity, inclusion, and the unique perspectives each team member brings. By joining us, you will have access to a competitive benefits package and the opportunity to advance your career in a supportive, forward-thinking environment. Qualified candidates will possess a current state nursing license, demonstrated expertise in inpatient coding, and a passion for fostering professional development among peers.
Clinical Coding Auditor RN - Summary- Develop, implement, and maintain comprehensive inpatient coding audit processes and training programs.
- Conduct audits and provide education to ensure compliance with coding standards and regulations.
- Support both new and existing staff through structured clinical education and ongoing professional development opportunities.
- Collaborate with management and staff to enhance operational effectiveness and coding accuracy.
- Primarily remote role with limited travel obligations.
- Design and update complex audit tools and processes related to inpatient coding practices.
- Lead the development and facilitation of clinical education courses for a diverse employee base.
- Audit medical necessity guidelines and ensure adherence to established protocols.
- Identify learning needs, select or develop appropriate training materials, and assess training effectiveness.
- Evaluate staff performance through regular audits, provide constructive feedback, and recommend actionable improvements to management.
- Maintain accurate records of training activities, audit results, and employee progress.
- Assist in revising organizational policies and procedures pertaining to inpatient coding as needed.
- Research and recommend internal and external training opportunities to support continuous staff development.
- Travel as required to support onsite training and auditing activities.
- Competitive salary structure, adjusted according to experience, education, and job-related factors.
- Eligibility for an annual performance bonus.
- Comprehensive benefits package, including health insurance, 401(k), stock purchase plans, tuition reimbursement, paid time off, and holidays.
- Flexible work arrangements to support work-life balance.
- Bachelor’s degree in Nursing or a related clinical field, or equivalent experience.
- Current, valid state nursing license required.
- Active inpatient coding certification (CPC, CIC, or CCS) is mandatory.
- Minimum of four years’ experience in nursing, training, or auditing within a managed care healthcare setting.
- At least one year of clinical experience in a hospital environment.
- Strong written English communication skills.
- Driver’s license may be required for certain positions.
- Demonstrated expertise in inpatient coding and auditing.
- Experience in a lead or supervisory role is highly desirable.
- Proven ability to develop and facilitate training programs for clinical staff.
- Detail-oriented with strong analytical, organizational, and problem-solving abilities.
- Adaptable and committed to ongoing professional growth and development.
- Collaborative team player with a proactive approach to identifying and resolving challenges.
- This position is primarily remote, with a minimal travel requirement for onsite training and auditing engagements.
- Applicants must be willing to travel as needed for organizational requirements.
- Company is an equal opportunity employer that values diversity and inclusivity in the workplace.
- All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other characteristic protected by law.
- Qualified applicants with arrest or conviction records will be considered in accordance with applicable regulations, including the LA County Ordinance and the California Fair Chance Act.
- Sponsorship is not available for this position.
Ready to advance your career as a Clinical Coding Auditor RN? Take the next step and apply today by clicking the job application button. Join a team dedicated to transforming healthcare and making a lasting difference in the lives of millions.