Clinical Coding Analyst RN, Consultant

The Clinical Coding Analyst RN, Consultant supports the Facility Compliance Review team by conducting in-depth quality audits of hospital claims to ensure compliance with ICD-10-CM, ICD-10-PCS, and other coding standards. This role involves reviewing medical records for medical necessity, appropriateness of billing, and reimbursement requirements while providing leadership and training to a small clinical coder team. The position requires strong clinical judgment, knowledge of DRG/APC methodologies, and the ability to collaborate with medical directors and cross-functional teams to resolve coding issues and improve quality of care.