Inpatient Clinical & Coding Specialist - Senior

U.S. Bankruptcy Court - District of CT; United States; Remote; USD 60,000 - 80,000; Full time

Job summary

A leading company is seeking a Clinical & Coding Specialist-Senior to review clinical coding and assist with audits. The role requires deep expertise in coding systems and experience in clinical settings. Candidates should possess relevant certifications and a strong analytical skill set. This position offers competitive hourly compensation, benefits, and opportunities for professional development.

Benefits

Benefits and paid time off included

Qualifications

• Minimum of one health information certification required (e.g., CIC, RHIA, RHIT).
• Four years of clinical setting experience required.
• Knowledge of facility contract reimbursement policies.

Responsibilities

• Review coding and clinical decisions on complex cases.
• Train team members and evaluate appeals based on audit trends.
• Support leadership in accomplishing all audit plan aspects.

Skills

Analytical skills

Critical thinking

Collaboration

Communication

Education

Associates degree

Bachelor’s degree (preferred)

Tools

Microsoft Word

Excel

ICD-10 coding systems

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.

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 required. 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 in reviewing healthcare delivery against clinical quality and financial guidelines.
Strong analytical and critical thinking skills. Ability to ensure clinical information translates into claim coding compliance. Capable of preparing studies and recalculating reimbursement following audits.
Autonomous worker with minimal supervision, process management skills, and expertise in coding systems and inpatient clinical knowledge.
Effective team player with ability to facilitate collaboration. Understanding of organizational and audit-related business strategies.
Excellent organizational, verbal, and written communication skills. Proficiency in Microsoft Word and Excel, with experience in remote access tools.
Knowledge of facility contract reimbursement policies.
Demonstrated embodiment of 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 included. Salary range subject to change.

As an Equal Opportunity / Affirmative Action Employer, Independent Health does not discriminate in employment practices based on protected characteristics under applicable law.