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Healthcare Medical Coding Analyst - Disputes, Claims & Investigations

Stout

Join Stout’s Healthcare Consulting practice to support complex coding audits, disputes, claims analysis, and investigations. This role focuses on inpatient medical record review, reimbursement analysis, forensic support, and client-ready reporting that informs regulatory responses, litigation support, and compliance decisions.

  • Perform detailed reviews of inpatient medical records for ICD-10-CM/PCS accuracy and alignment with clinical documentation
  • Analyze coding, billing, and reimbursement practices across audits, disputes, and investigations
  • Support forensic analyses to identify compliance risks, inefficiencies, and reimbursement discrepancies
  • Assist with audits, regulatory reviews, and litigation support by gathering evidence and documenting findings
  • Evaluate DRG/APR-DRG/APC assignments and reimbursement implications
  • Collaborate with internal teams, clients, and legal counsel
  • Prepare structured reports, analyses, and recommendations
  • Monitor coding trends, denials, billing edits, and regulatory updates
Requirements & Qualifications

To be successful in this role, you should bring strong inpatient coding expertise, audit experience, and knowledge of reimbursement frameworks.

  • Bachelor’s degree in Health Information Management or related field, or equivalent experience
  • Minimum 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, and APC methodologies
  • Experience reviewing clinical documentation for accuracy, compliance, and reimbursement optimization
  • Familiarity with CMS, HIPAA, and False Claims Act considerations
  • Proficiency in Microsoft Office; data visualization experience is a plus
  • Strong analytical, problem-solving, and communication skills
Benefits & Perks

Stout offers a competitive Total Rewards program and a supportive work environment.

  • Medical insurance
  • Vision insurance
  • Dental insurance
  • 401(k)
  • Annual bonus plan eligibility
  • Flexible work schedules
  • Discretionary time off
  • Ongoing training and mentorship

Location

Washington, District of Columbia, US

Employment Type

Full-time

Experience Level

Senior

Salary Range

$60,000 - $130,000

Remote work allowed

No

Posted

4 weeks ago

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