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R1RCM3 weeks ago

Coding Integrity Specialist

$88,400–$94,640 year

Remote · United States or US

Type
Full Time
Level
Mid Level
Education
Bachelors Degree
Company size
Enterprise

Job Summary

Coding Integrity Specialist responsible for leading, coordinating, and performing complex coding quality reviews related to reimbursement and public reporting. Works with CDI team to resolve documentation inconsistencies, DRG variances, and ensure KPIs/SLA/RIS/DNFB requirements. Evaluates coding accuracy to optimize revenue and case mix, provides education to coders, identifies coding trends for formal education, and conducts focused pre-bill and post-bill reviews, including review for medical necessity and billing/charging accuracy. Requires strong analytical skills, ability to review complex medical records, and experience in inpatient coding with CCS or a HIM-related degree. Compensation includes hourly pay in the US range and 5+ years of experience in a healthcare revenue-management environment.

Required Qualifications

  • Bachelor's or associate’s degree in HIM related fields or CCS credential is required.
  • Minimum 5 years of inpatient coding.
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$88k – $95k / yr

Coding Integrity Specialist · R1RCM

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