Documentation & Risk Coding Analyst Senior - Hospital Based

Monday through Friday - First Shift

This is a remote opportunity

Will support - Hospital Based Coding

Pay Range

Major Responsibilities:

• Ensure compliance with regulatory coding standards, including CMS, QIOs, NCCI edits, and payer-specific requirements, while adhering to AHIMA’s Standards of Ethical Coding. 

• Review clinical documentation and diagnostic results in the EHR to assign accurate ICD-10-CM/PCS and CPT/HCPCS codes that support organizational and Clinician Services initiatives. 

• Query providers when documentation is unclear, following established policies to ensure coding accuracy and completeness. 

• Collaborate with cross-functional teams—including Coding, CDI, CMD, and Quality—to advance documentation improvement practices and align with enterprise goals. 

• Participate in special projects that support documentation, compliance, and operational excellence. 

• Participate in the development and execution of sub-function initiatives.  

• Mentor and provide onboarding for Documentation and Risk Coding Analysts.  

• In coordination with leadership, monitor daily activities and workflows to ensure timely execution to ensure alignment and efficiency.   

• Promote a professional, team-oriented service culture, modeling collaboration and accountability across Clinician Services and partner departments. 

• Identify improvement opportunities through analysis and review, partnering with leadership and team members to implement enhancements. 

• Demonstrate technical proficiency in using EHR systems, coding software, and official coding resources to support accurate and efficient documentation. 

• Maintain confidentiality of patient records, and report any non-compliant practices to Documentation and Risk leadership or compliance officers. 

• Engage in continuous learning, staying current with evolving coding guidelines, terminology, and best practices through training, publications, and credential maintenance

Licensure, Registration, and/or Certification Required:

• Clinical or operational credential required. May include licensure as a clinically practicing professional (e.g., RN, RT, LCSW) or certification in healthcare operations or project management (e.g., PMP, LSSGB, HFMA-CRCR). 

• Certification in mid-revenue cycle operations from a recognized professional organization such as AHIMA, AAPC, or HFMA is required. 

• A second mid-revenue cycle certification is required. Candidates without a second certification in mid-revenue cycle from a recognized professional organization will be required to obtain one within 12 months of hire. 

Education Required:

• Completion of advanced training in revenue cycle management through a recognized or accredited program, equivalent in scope and rigor to post-secondary education. High school diploma or GED required. 

Experience Required:

• Minimum of 5 years of healthcare experience, including at least 2 years working as a clinician or in direct partnership with clinicians or a recognized profession supporting clinicians (i.e, CDI, CMD or informatics), with demonstrated involvement in clinical documentation, coding, or documentation improvement initiatives. 

Knowledge, Skills & Abilities Required:

• Extensive knowledge of third-party reimbursement programs, state and federal regulatory issues, national and local coverage determinants, research-related restrictions, ICD-10 CM/PCS, and CPT/HCPCS coding classifications. 

• Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA), adheres to official coding guidelines as well as the organizational and departmental guidelines, policies and protocols. 

• Demonstrated proficiency in Microsoft Office Suite (Word, Excel, PowerPoint, Teams, etc.) or similar products and in patient accounting and billing systems. 

• Ability to deal and work effectively with multiple departments and in matrix organizational structures. Proven ability to influence others not directly reporting to them. Strong oral and written communication skills. 

• Strong understanding of medical terminology, anatomy, and physiology to support precise code assignment. 

• Highly proficient in problem-solving and strong attention to detail. 

• Advanced knowledge of Epic. 

Physical Requirements and Working Conditions:

• Follows organizational and divisional remote work policy and guidelines. 

• Operates all equipment necessary to perform the job.  

• Handles a fast paced and creative work environment moving independently from one task to another. 

• Makes sound decisions within limited time frames and always conducts business in a professional manner and has demonstrates ability to work cooperatively and effectively with others on an individual and team basis. 

• This position may require travel, therefore, will be exposed to weather and road conditions. 

Preferred Job Requirements/ Preferred Education:

• Advanced training beyond High School that may include the completion of an accredited or approved program in Medical Coding and/or associate or bachelor's degree preferred. 

Preferred Certification / License:

• Second certification through AHIMA, CPC, or HFMA preferred. 

DISCLAIMER

All responsibilities and requirements are subject to possible modification to reasonably accommodate individuals with disabilities.

This job description in no way states or implies that these are the only responsibilities to be performed by an employee occupying this job or position.  Employees must follow any other job-related instructions and perform any other job-related duties requested by their leaders.

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Our Commitment to You:

Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including:

Compensation

• Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training
• Premium pay such as shift, on call, and more based on a teammate's job
• Incentive pay for select positions
• Opportunity for annual increases based on performance

Benefits and more

• Paid Time Off programs
• Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
• Flexible Spending Accounts for eligible health care and dependent care expenses
• Family benefits such as adoption assistance and paid parental leave
• Defined contribution retirement plans with employer match and other financial wellness programs
• Educational Assistance Program