Inpatient Coding Review Specialist (H)

University of Miami • Medley, FL

80d

About The Position

The University of Miami/UHealth - Health Information Management Department has an exciting opportunity for a full-time Inpatient Coding Review Specialist (H) to work remotely. The Inpatient Coding Review Specialist (H) under the general direction of the Inpatient Coding Manager works closely with the University of Miami Health’s Clinical Documentation Improvement Specialists (CDIS) as well as Quality Management Analysts to ensure accurate and compliant coding on all Mortality cases prior to billing. The Inpatient Coding Review Specialist also performs quality reviews that specifically focus on the identification and validation of Hospital Acquired Conditions (HACs), Patient Safety Indicators (PSIs), Present on Admission status, complications, and comorbidities that impact USNWR rankings and Vizient quality measures.

Requirements

• High School diploma or equivalent.
• Minimum 5 years of relevant experience.
• Ability to learn new procedures, technologies, and protocols, and adapt to changing priorities and work demands.
• Ability to work collaboratively with others and contribute to a team environment.
• Skilled in using office software, technology, and relevant computer applications.
• Strong and clear written and verbal communication skills for interacting with colleagues and stakeholders.

Nice To Haves

• Any relevant education, certifications and/or work experience may be considered.

Responsibilities

• Reviews, analyzes, and interprets the complete electronic medical record (EMR) after initial coding to identify missed coding opportunities supported by documentation.
• Validates the assigned principal diagnosis, significant secondary ICD-10-CM diagnosis codes, Present On Admission (POA) indicators, and ICD-10-PCS procedure codes to ensure compliance with ICD-10-CM/PCS Official Coding Guidelines, UHDDS, and regulatory requirements for accurate MS-DRG assignment.
• Ensures accurate capture of Severity of Illness (SOI) and Risk of Mortality (ROM) indicators.
• Applies knowledge of the Elixhauser Comorbidity Index and Vizient quality measure logic, focusing on specialty-specific conditions that impact MCC/CC capture and quality data reporting.
• Collaborates with CDI, quality teams, and physicians to clarify ambiguous or incomplete documentation through the provider query process.
• Participates in meetings with CDI, providers, and colleagues to discuss coding findings, share expertise, and defend coding decisions using documentation and official guidelines.
• Conducts POA reviews for cases marked 'No' and provides feedback to leadership for coder education and improvement.
• Reviews denial cases and provides detailed feedback to the Revenue Cycle Director and Audit Specialists.
• Assists in resolving claim edits across all accounts, regardless of the initial coder assignment.
• Performs initial inpatient coding when primary responsibilities are complete or additional hours are approved.
• Meets or exceeds established quality and productivity benchmarks set by leadership.
• Adheres to University and unit-level policies and procedures and safeguards University assets.

Benefits

• Competitive salaries.
• Comprehensive benefits package including medical, dental, tuition remission and more.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED
• Number of Employees: 11-50 employees