Major Responsibilities:

Monitor and analyze KPIs to identify trends and transform data into actionable reports and presentations that support strategic decision-making.Collaborate with leadership and cross-functional teams—including Coding, CDI, CMD, Quality, and Clinical Informatics—to identify improvement opportunities and advance documentation practices.Provide operational and technical guidance to staff and stakeholders, ensuring clarity and consistency in documentation and coding processes.Review clinical documentation and diagnostic results to ensure accurate assignment of ICD-10-CM/PCS and CPT/HCPCS codes in alignment with organizational initiatives.Query providers when documentation is unclear, following established policies to ensure coding accuracy and compliance.Demonstrate compliance with regulatory requirements, including CMS, QIOs, NCCI edits, and payer-specific guidelines, while adhering to AHIMA’s Standards of Ethical Coding.Utilize EHR systems and coding tools proficiently, maintaining data integrity and supporting efficient documentation workflows.Maintain confidentiality of patient records and report any non-compliant practices to appropriate leadership or compliance officers.Engage in continuous learning, staying current with evolving coding guidelines, practices, and terminology through training and professional development.Promote a collaborative, service-oriented culture, modeling professionalism and teamwork across Clinician Services and organizational stakeholders.

Licensure, Registration, and/or Certification Required:

RHIA or HIT or CCS or CCS-P or CPC;  Specialty credential required within one year of employment.

Education Required:

Completion of advanced training in revenue cycle management through a recognized or accredited program, equivalent in scope and rigor to post-secondary education. High school diploma or GED required. 

Experience Required:

5 years of experience in expert-level professional and/or facility coding, and experience in collaborating with other teams within an organization, and/or educating/training licensed clinicians. Advanced level of ICD-10- CM/PCS and/or ICD-10-CM/CPT/HCPS for a large complex health care system or medical group.

Knowledge, Skills & Abilities Required:

Extensive knowledge of third-party reimbursement programs, state and federal regulatory issues, national and local coverage determinants, research-related restrictions, ICD-10 CM/PCS, and CPT/HCPCS coding classifications.Proficiency in statistical analysis is essential to examine revenue cycle/reimbursement activities and identify and address related issues.Demonstrated proficiency in Microsoft Office Suite (Word, Excel, PowerPoint, Teams, etc.) or similar products and in patient accounting and billing systems.Ability to deal and work effectively with multiple departments and in matrix organizational structures. Proven ability to influence others not directly reporting to them. Strong negotiating skills. Strong oral and written communication skills.Strong understanding of medical terminology, anatomy, and physiology to support precise code assignment.Highly proficient in problem-solving and analytical thinking with strong attention to detail.Advanced knowledge of Epic and other reporting tools to analyze data, generate reports, and optimize workflow efficiencies

Physical Requirements and Working Conditions:

Follows organizational and divisional remote work policy and guidelines. Operates all equipment necessary to perform the job.  Handles a fast paced and creative work environment moving independently from one task to another. Makes sound decisions within limited time frames and always conducts business in a professional manner and has demonstrates ability to work cooperatively and effectively with others on an individual and team basis. This position may require travel, therefore, will be exposed to weather and road conditions. 

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.

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