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Coding Audit & Compliance Administrator
Jefferson Health

Location: Philadelphia, Pennsylvania
Work Setting: Hospital
Job Function:
Auditor, Compliance
Job Type:


Jefferson Health, with 14 hospitals (seven are Magnet designated by the ANCC for nursing excellence) and 40+ outpatient and urgent care locations, offers a broad range of primary and complex, highly specialized care that touches the lives of more than four million patients annually. U.S. News & World Report has ranked Thomas Jefferson University Hospital among the nation’s best in 10 specialties. Jefferson Health also includes the NCI designated Sidney Kimmel Cancer Center; it is one of only 70 such centers in the nation.


Jefferson (Philadelphia University + Thomas Jefferson University) has ten colleges and three schools that offer more than 160 undergraduate and graduate programs. Our University is dedicated to inter-professional and transdisciplinary approaches to learning that offer a vibrant and expandable platform for professional education. Through this unique model, we are preparing our students for current and yet to be imagined careers.



Job Description

Primary Responsibilities

Coding Audit and Compliance Administrator has the responsibility for developing, implementing and maintaining a data quality compliance plan for inpatient and outpatient coding and reimbursement. The Coding Audit and Compliance Administrator will assist the Senior Director of Health Information Management and Director of Coding and Data Operations with the development of coding policies and procedures. Coordinates and conducts reviews of targeted cases to assure timely billing process and correct hospital reimbursement. Performs daily and random audits to validate accuracy of MSDRG, APC and coding assignments to ensure compliance with coding and billing requirements.

Essential Functions

•Responsible for developing, implementing and maintaining a coding quality compliance plan for outpatient coding and reimbursement
•Coordinates and conducts daily reviews of targeted cases to assure timely billing process and correct hospital reimbursement
•Perform random audits and reviews on denied cases to validate accuracy of MS-DRG and APC coding assignments to ensure compliance with coding and billing requirements
•Perform follow-up and focused audits as directed and as necessary
•Serve as a resource for coding, charging, and billing staff from TJUH facilities who have questions and seek clarification
•Interacts with co-workers, visitors, and other staff consistent with the core values of the Hospital.

Required Qualifications


Certified Coding Specialist (CCS) required.

Registered Health Information Administrator (RHIA) preferred
OR Registered Health Information Technologist (RHIT) preferred.

Experience Requirements

Minimum of five years previous coding and coding auditing experience required.

Education Qualifications

Educational / Training Requirements

High School Diploma or GED required. Bachelor’s degree preferred.

Instructions for Resume Submission

As an employer, the Jefferson Enterprise maintains a commitment to provide equal access to employment. Jefferson values diversity and encourages applications from women, members of minority groups, LGBTQ individuals, disabled individuals, and veterans.

Instructions for Resume Submission: Apply on line: Job ID #9224421

Apply Online:

Posted: January 22, 2019 at 12:23 PM
Post ID: 35164

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