Clinical Coding Qualified Auditor

Role Overview

We are seeking an experienced Clinical Coding Qualified Auditor responsible for ensuring the accuracy, quality, and compliance of clinical coding through independent coding audits, quality reviews, and continuous improvement initiatives. The role requires expertise in ICD-10, OPCS-4, clinical documentation review, and coding quality assurance.

Key Responsibilities

• Conduct coding audits and re-code complex inpatient cases to assess coding accuracy and compliance.
• Review clinical records and assign accurate ICD-10 and OPCS-4 codes where required.
• Identify coding errors, trends, and documentation gaps, providing recommendations for improvement.
• Collaborate with clinicians to clarify diagnoses, procedures, and ambiguous documentation.
• Prepare coding quality reports and support internal and external audit activities.
• Provide technical guidance, mentoring, and quality feedback to coding team members.
• Support training programs and promote adherence to coding standards and best practices.

Essential Qualifications

• NCCQ Accredited Clinical Coder (ACC) or equivalent clinical coding certification.
• Minimum 3+ years of post-accreditation clinical coding experience.
• Strong knowledge of ICD-10, OPCS-4, clinical coding standards, and audit methodologies.
• Clinical Coding Standards Refresher Certification completed within the last 3 years.

Essential Experience & Skills

• Experience coding inpatient episodes across multiple specialties.
• Experience performing coding audits, quality checks, or coding validation activities.
• Strong understanding of medical terminology, anatomy & physiology, and clinical documentation.
• Experience using Electronic Health Records (EHR), Patient Administration Systems (PAS) and other clinical systems.
• Strong analytical, reporting, stakeholder management, and mentoring skills.

Preferred

• Approved Clinical Coding Auditor certification (or willingness to obtain).
• Experience leading coding quality improvement initiatives and supporting external audits.