Pre-Bill Coder Specialist

About the Role

We are seeking an experienced Senior Inpatient Coder to join our Health Information Management team. In this role, you will prioritize, abstract, and accurately code high-dollar charts from acute care tertiary facilities, ensuring compliance with federal regulations, payer guidelines, and official coding standards. This position is ideal for a highly skilled coding professional with extensive inpatient experience and a strong understanding of revenue cycle processes, clinical documentation improvement (CDI), and health information workflows.

Key Responsibilities

  • Review complex medical documentation from clinicians, qualified health professionals, and hospitals to assign diagnosis and procedure codes using ICD CM/PCS, CPT, and HCPCS.

  • Assign codes for Present on Admission (POA), Hospital-Acquired Conditions (HACs), Core Measure Indicators, and research documentation both concurrently and post-discharge.

  • Ensure correct code selection following Official Coding Guidelines, payer requirements, and compliance standards using EMR and/or Computer Assisted Coding (CAC) software.

  • Collaborate with clinical staff, HIM, CDI, Patient Accounts, and Integrity teams to clarify documentation and optimize reimbursement and clinical outcomes.

  • Process claim edits for all patient types and manage consecutive/combined accounts per 72-hour rules.

  • Perform informal peer reviews for inpatient and outpatient coders.

  • Track and analyze coding quality data to identify opportunities for education and workflow improvement.

  • Maintain current knowledge of coding, reimbursement, and regulatory updates, applying critical decision-making to independently query for documentation clarification.

Required Qualifications

  • Coding Certification from AAPC or AHIMA.

  • Associate’s Degree in Health Information Management or a related field.

  • Minimum 7 years of inpatient coding experience in an acute care tertiary facility, including exposure to revenue cycle processes, CDI, research, and health information workflows.

  • Strong proficiency with EMR systems and computer-assisted coding software.

Skills & Competencies

  • Advanced understanding of inpatient coding guidelines and compliance requirements.

  • Excellent analytical and critical thinking skills.

  • Strong collaboration and communication skills to liaise with clinicians and cross-functional teams.

  • Ability to manage high-volume, high-complexity charts with accuracy and attention to detail.

Working Conditions

  • Office-based environment with the ability to sit for extended periods.

  • May require travel to other sites and exposure to road and weather hazards.

  • Operates necessary equipment to perform coding and HIM duties.


APPLY

Apply for this position

Allowed Type(s): .pdf, .doc, .docx