Inpatient Coding Specialist

Job Summary

A company is looking for a Coder Policy Specialist - Remote.

Key Responsibilities

• Develop clinical and coding products to enhance claim selection processes and payment integrity
• Conduct data analysis and research to innovate coding solutions and refine claim selection methodologies
• Monitor program performance and recommend changes to improve outcomes

Required Qualifications

• 7-10 years of experience in reviewing and auditing ICD 10 CM/PCS, MS-DRG, and proficient with encoder products
• Inpatient Coding Certification required (e.g., CCS, CIC, RHIA, RHIT) with inpatient coding experience
• 5+ years of experience with healthcare policy and Medicare guidelines
• Ability to research and interpret State and Federal regulations and coding guidelines
• Experience in developing clinical/coding resources and supporting clinical claim review products