Clinical Coding Analyst (Remote)

The Clinical Coding Analyst plays a critical role in ensuring accurate reimbursement, regulatory compliance, and documentation integrity for healthcare clients. This position directly impacts hospital revenue performance, coding compliance, and quality metrics by identifying opportunities, mitigating risks, and supporting physician documentation improvement.

This role ensures that coding accuracy and revenue integrity are optimized while maintaining strict adherence to Medicare regulations and ICD-10 standards.

• Perform daily pre-bill chart reviews and communicate recommendations within 24 hours

• Review electronic health records for revenue opportunities and coding compliance issues

• Provide verbal reviews with physicians regarding MS-DRG recommendations and query opportunities

• Upload and document case data into MS DRG Database accurately

• Prepare reimbursement recommendations (increase, decrease, or informational)

• Review and respond to client questions and rebuttals within required timelines

• Review and appeal Medicare and third-party denials when appropriate

• Analyze 30-Day Readmissions and Mortality quality measures for Medicare cohorts

• Maintain system access across assigned client sites

• Stay current with ICD-10-CM/PCS updates, AHA Coding Clinics, and Medicare regulations

• Utilize internal coding tools (TruCode, CDocT)

• Adhere to company policies and compliance standards

• AHIMA credential: CCS or CDIP, or ACDIS credential: CCDS (Required)

• AHIMA Approved ICD-10 CM/PCS Trainer (Preferred)

• RHIT or RHIA credential (Preferred)

• Minimum 7 years acute inpatient hospital coding, auditing, and/or CDI experience

• Extensive ICD-10 CM/PCS knowledge

• Experience with CDI programs preferred

• Experience with EHR systems (Cerner, Meditech, Epic, etc.)

• Prior remote work experience required

• Strong analytical, communication, and organizational skills

• Proficiency in Microsoft Word and Excel

• Ability to work independently

Flexible schedule within 7:30 AM – 6:00 PM EST
Two required daily 20-minute physician meetings
Company core hours: 8:00 AM – 5:00 PM EST/CST

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