Coding Integrity Specialist

R1 RCM

Coding Integrity Specialist ensuring proper coding and reimbursement for healthcare providers while collaborating with various teams to address documentation issues. Conducting coding reviews and providing feedback to coding professionals.

Posted 7/10/2026full-timeRemote • 🇺🇸 United StatesMid-LevelSenior💰 $43 - $46 per hourWebsite

About the role

Key responsibilities & impact

Conduct complex coding reviews related to reimbursement, public reporting, and pay for performance.
Collaborates with the CDI team, assisting with the resolution of documentation inconsistencies, DRG variances, and CDI and internal operations.
Ensures that the DRG or reimbursement accurately reflects the services/utilization of resources provided by the hospital.
Performs second level focused pre-bill and post-bill account reviews to ensure accurate coding.
Conduct complex 360 coding reviews which include identification and correction of coding, and trending for documentation, coding denials, billing, and charging.
Evaluate for coding accuracy/specificity to assist with preventing possible loss of revenue for the hospital related to value-based payment programs.

Requirements

What you’ll need

Bachelor's or associate’s degree in HIM related fields or CCS credential is required.
Minimum 5 years of inpatient coding.

Benefits

Comp & perks

Health insurance
401(k) matching
Paid time off
Flexible working arrangements
Professional development opportunities
Competitive benefits package

ATS Keywords

✓ Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools

Coding AccuracyDocumentation ReviewBilling ComplianceCoding Denials AnalysisPre-Bill Account ReviewPost-Bill Account ReviewResource Utilization AssessmentTrend Analysis

Soft Skills

CollaborationProblem SolvingAttention to Detail

Certifications

CCS Credential