Inpatient Clinical & Coding Specialist - Senior

Southern Arizona Legal Aid Inc.; United States; Remote; USD 60,000 - 80,000; Full time

Job summary

A leading legal aid organization seeks a Clinical & Coding Specialist-Senior to review complex clinical coding cases. This role involves training team members, evaluating appeals, and supporting hospital audits while demonstrating expertise in coding systems. Ideal candidates will bring strong analytical, organizational, and communication skills, along with relevant certifications and experience.

Benefits

Benefits included

Paid time off

Qualifications

• Associates degree required; Bachelor's preferred.
• One of several healthcare coding certifications required.
• Four years experience in clinical settings utilizing ICD-10 coding.

Responsibilities

• Review coding and clinical decisions on complex cases.
• Train team members and evaluate appeals.
• Support Hospital Audit leadership in executing audit plans.

Skills

Analytical skills

Critical thinking

Organizational skills

Communication skills

Team collaboration

Education

Associates degree

Bachelor's degree

Tools

Microsoft Word

Microsoft Excel

Job description

The Clinical & Coding Specialist-Senior will be responsible for reviewing coding and clinical decisions on cases involving complex clinical presentations with correlating coding complexity. They will aid in training other team members, evaluating appeals, and sharing audit trends across the team. Expertise and proficiency demonstrated by long-standing, consistent results, advanced coding knowledge, and auditing skills evidenced by their ability to train others, identify coding patterns, and share knowledge and audit tips across the team. The Clinical & Coding Specialist-Senior will support leadership in Hospital Audit to accomplish all aspects of the audit plan.

Requirements include:

• Associates degree required; Bachelor’s degree preferred. An additional two (2) years of experience may be considered in lieu of degree.
• Minimum of one of the following certifications or licensures: Certified Inpatient Coder (CIC), Registered Health Information Management Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Clinical Documentation Specialist (CCDS), American Health Information Management Association (CCS-H, CCS-P), Certification Denials and Appeals Management (C-DAM), or NYS licensed RN or LPN. LPN or RN preferred.
• Four (4) years of experience working in a clinical setting or utilizing a coding system (ICD-10 or PCS) required. Coding audit experience in an inpatient setting preferred.
• Knowledge of ICD-10-CM and ICD-10-PCS coding systems, as well as respective reimbursement methodologies, preferred.
• Experience and proficiency reviewing healthcare delivery against clinical quality and financial guidelines.
• Strong analytical and critical thinking skills, with the ability to ensure correct translation of clinical information into claim coding compliance, and to prepare quantitative and qualitative audit studies.
• Ability to recalculate reimbursement following audits in accordance with contracts and policies.
• Autonomous worker with minimal supervision, process management skills, and subject matter expertise in coding systems or inpatient clinical expertise.
• Effective team collaboration skills and understanding of organizational and reimbursement strategies.
• Excellent organizational, verbal, and written communication skills, with proficiency in Microsoft Word and Excel. Experience with remote access tools is also required.
• Knowledge of facility contract reimbursement policies.
• Demonstrated alignment with IH values: Passionate, Caring, Respectful, Trustworthy, Collaborative, and Accountable.

Hiring Compensation Range: $33.50 - $38.00 hourly. Compensation may vary based on skills, education, location, and experience. Benefits and paid time off are included. The salary range is subject to change.

Independent Health is an Equal Opportunity / Affirmative Action Employer, committed to non-discriminatory employment practices regardless of protected characteristics.