Senior HIM & Coding Consultant
Remote
Job Summary
Review clinical documentation to ensure coding accuracy and billing compliance for ICD-10-CM, ICD-10-PCS, CPT, and HCPCS practices. Validate coded encounters, support claim reconstruction, and identify documentation gaps affecting reimbursement. Collaborate with HIM, Coding, Clinical Documentation Integrity, and Revenue Integrity teams to analyze denied claims and recommend process improvements. Produce findings and recommendations for project leadership while assisting with documentation audits. This project-based W2 consulting engagement is primarily remote with occasional onsite meetings in the Chicago metro area. You will join an experienced team supporting a large-scale hospital revenue recovery initiative to restore accurate billing and critical hospital operations.
Required Qualifications
- Health Information Management (HIM) expertise
- Clinical documentation expertise
- Medical coding expertise
- Revenue cycle operations expertise
- Experience validating clinical documentation
- Experience assessing coding accuracy
- Experience supporting claim reconstruction
- Experience identifying opportunities to improve documentation and reimbursement processes
- Knowledge of ICD-10-CM coding practices
- Knowledge of ICD-10-PCS coding practices
- Knowledge of CPT coding practices
- Knowledge of HCPCS coding practices
- Ability to review clinical documentation to ensure coding accuracy and billing compliance
- Ability to assess documentation quality and identify coding gaps affecting reimbursement
- Ability to validate coded encounters
- Ability to review denied claims and identify documentation or coding issues contributing to payment delays
- Ability to recommend process improvements that enhance coding accuracy and revenue cycle performance
- Ability to assist with documentation audits and coding validation efforts
- Ability to produce findings and recommendations for project leadership
- W2 employment classification
- Ability to work primarily remote
- Ability to attend occasional onsite meetings in the Chicago metropolitan area
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