Analyst, Healthcare Medical Coding - Disputes, Claims & Investigations

Impact You’ll Make This role will contribute to complex healthcare consulting engagements involving coding audits, disputes, claims analysis, and investigations. You will deliver high‑quality accuracy in coding analysis informing client decisions, regulatory responses, and litigation support. Your work will identify billing, coding, and reimbursement risks—including potential fraud, waste, and abuse—and support the development of defensible findings and recommendations. By applying deep expertise in inpatient coding, reimbursement systems, and compliance, you will enhance Stout’s reputation for excellence. What You’ll Do Perform detailed reviews of inpatient medical records to assess ICD‑10‑CM/PCS coding accuracy and alignment with clinical documentation. Analyze coding, billing, and reimbursement practices for audits, disputes, and investigations. Support forensic analyses to identify compliance risks, inefficiencies, and reimbursement discrepancies. Assist in audits, regulatory reviews, and litigation support by gathering evidence, analyzing issues, and contributing to reporting. Evaluate DRG/APR‑DRG/APC assignments and reimbursement implications based on clinical documentation. Collaborate with internal teams, clients, and legal counsel to support engagement objectives. Prepare clear, well‑structured reports, analyses, and client‑ready deliverables summarizing findings and recommendations. Monitor coding trends, denials, billing edits, and regulatory updates to inform analyses and engagement insights. Contribute to internal knowledge sharing and continuous improvement within the Healthcare Consulting practice. What You Bring Bachelor’s degree in Health Information Management or related field (or equivalent experience). Minimum of five (5) years of recent acute‑care inpatient facility coding experience. Strong experience with DRG and PCS coding, including auditing; denials experience preferred. Active coding credential required (CCS, CIC, RHIT, or RHIA). Knowledge of MS‑DRG, APR‑DRG, APC methodologies and reimbursement frameworks. Experience reviewing clinical documentation for accuracy, compliance, and reimbursement optimization. Familiarity with healthcare regulatory frameworks (CMS, HIPAA, False Claims Act). Proficiency in Microsoft Office (Excel, Word, PowerPoint); experience with data visualization tools is a plus. Strong analytical, problem‑solving, and written/verbal communication skills. How You’ll Thrive Analytical and Detail‑Oriented: Interpret complex clinical and coding data and draw well‑supported conclusions. Collaborative and Client‑Focused: Work effectively with cross‑functional teams and build strong client relationships. Accountable and Proactive: Take ownership of work, manage priorities, and deliver high‑quality results on time. Adaptable and Curious: Thrive in a fast‑paced consulting environment and continuously learn new regulations and methodologies. Quality and Integrity Driven: Demonstrate commitment to ethical coding practices and compliance standards. Aligned with Stout Values: Embody Relentless Excellence through teamwork, responsiveness, and strong communication. Compensation: $60,000 – $130,000 annual. Eligible to participate in an annual bonus plan. Stout is an Equal Employment Opportunity. All qualified applicants will receive consideration for employment on the basis of valid job requirements, qualifications and merit without regard to race, color, religion, sex, national origin, disability, age, protected veteran status or any other characteristic protected by applicable local, state or federal law. Stout is required by applicable state and local laws to include a reasonable estimate of the compensation range for this role. The range was not adjusted for any geographic differential associated with the location at which the position may be filled. It is not typical for an individual to be hired at or near the top of the range, and compensation decisions are dependent on each case. #J-18808-Ljbffr Stout Risius Ross