Inpatient Coding Specialist

Job Summary

A company is looking for a Coder Policy Specialist to develop and manage clinical and coding products while providing subject matter expert support.

Key Responsibilities

• Develop content and innovative strategies for clinical and coding products, focusing on payment integrity
• Conduct data analysis and research to enhance coding solutions and claim selection methodologies
• Monitor program performance and present results to clinical leadership, recommending improvements as needed

Required Qualifications

• 7-10 years of experience in reviewing and auditing ICD 10 CM/PCS, MS-DRG, and other coding claims
• Inpatient Coding Certification (e.g., CCS, CIC, RHIA, RHIT) required; RN with coding credentials preferred
• 5+ years of experience with healthcare policy and Medicare guidelines
• Deep understanding of inpatient and outpatient billing and coding audits
• Ability to research and implement clinical policies and coding resources