About this role
Role Overview
Apply your medical coding and health information management leadership experience to evaluate AI-powered coding outputs and help improve healthcare AI systems. This role focuses on professional fee and/or inpatient facility coding, using your expertise to strengthen coding accuracy, productivity, and compliance.
Key Responsibilities
- Lead or oversee professional fee and/or inpatient facility coding operations with a focus on accuracy, productivity, and coding-guideline compliance.
- Review AI-generated ICD-10-CM/PCS diagnoses and procedure codes, CPT/HCPCS codes, and DRG assignments for accuracy and compliance.
- Perform coding quality audits and deliver targeted feedback to coding staff and AI systems.
- Track coding KPIs, including coder productivity, accuracy rates, unbilled accounts, and coding-related claim denials.
- Manage coding work queues, work distribution, and turnaround-time compliance.
- Maintain adherence to Official Coding Guidelines, CMS regulations, and payer-specific coding requirements.
- Provide coding education and compliance training.
- Partner with CDI, billing, and compliance teams to resolve coding-related revenue-integrity issues.
- Annotate AI-generated coding outputs and provide structured feedback for AI training datasets.
Qualifications
- At least 5 years of medical coding experience, including 2 or more years in a coding manager or HIM leadership role.
- Expert knowledge of ICD-10-CM/PCS, CPT/HCPCS, and Official Coding Guidelines.
- Professional fee coding and/or inpatient facility coding expertise, including DRG assignment experience.
- Experience conducting coding audits and building coding quality-improvement programs.
- Proficiency with coding software such as 3M, Nuance, Optum360, or TruCode, as well as EHR platforms.
- Exceptional written and verbal English communication skills.
- Strong attention to detail and the ability to identify coding errors, compliance risks, and inaccuracies in AI outputs.
Preferred Qualifications
- CPC, CCS, RHIA, or RHIT credential.
- Experience with computer-assisted coding tools and NLP-based coding platforms.
- Inpatient facility coding background with DRG optimization experience.
- Familiarity with AI coding tools and evaluating AI-generated coding assignments.
- Experience presenting coding performance data and quality metrics to leadership.
Work Terms
- Remote, hourly engagement.
- Independent contractor role.
Compensation
- $80 per hour.