Ocean Health Executives is seeking an experienced and detail-oriented Inpatient Rehabilitation Facility (IRF) Coder to join the coding and compliance team. The role focuses on concurrent review of inpatient rehabilitation medical records, accurate ICD-10-CM diagnosis code assignment, IRF-PAI data validation, and compliant reimbursement support under the Medicare IRF Prospective Payment System (PPS).
The position requires strong knowledge of IRF coding guidelines, rehabilitation documentation requirements, Case-Mix Group (CMG) assignment, comorbid condition review, and collaboration with clinical and CDI teams to ensure coding accuracy and regulatory compliance.
Responsibilities
- Perform concurrent and retrospective coding review for inpatient rehabilitation encounters
- Assign accurate ICD-10-CM diagnosis codes in accordance with Official Coding Guidelines and payer-specific requirements
- Review and validate IRF-PAI documentation and coding elements impacting CMG assignment and reimbursement
- Identify and validate comorbid conditions, complications, and tier-impacting diagnoses
- Review physician documentation for completeness, specificity, and coding support
- Communicate documentation clarification opportunities to providers and CDI teams as appropriate
- Ensure coding accuracy, compliance, and timely completion of assigned work queues
- Maintain productivity and quality standards established by the organization and client
- Participate in internal QA reviews, education sessions, and coding updates
- Collaborate with coding leadership, CDI specialists, and operational teams to resolve coding and documentation issues
- Maintain current knowledge of CMS regulations, IRF PPS updates, ICD-10-CM coding changes, and rehabilitation documentation requirements
Qualifications
- Minimum 3–5 years of inpatient coding experience required
- Minimum 1–2 years of IRF coding experience strongly preferred
- Strong knowledge of IRF Prospective Payment System (PPS)
- Experience with IRF-PAI review and validation
- Knowledge of ICD-10-CM coding guidelines
- Understanding of rehabilitation documentation requirements
- Familiarity with Medicare regulations and compliance standards
- Experience performing concurrent review preferred
- Familiarity with Epic or other electronic medical record systems preferred
- Strong analytical, organizational, and communication skills
- Ability to work independently in a remote environment
- Must maintain strict confidentiality and HIPAA compliance
Required Credentials
One or more of the following credentials is required:
- AHIMA Certified Coding Specialist (CCS)
- AHIMA Registered Health Information Administrator (RHIA)
- AHIMA Registered Health Information Technician (RHIT)
Preferred Experience
- IRF concurrent coding and review
- IRF-PAI auditing or validation
- CDI collaboration
- Medicare rehabilitation reimbursement methodologies
- Remote coding production environments
- Quality auditing experience
Experience
- IRF coding: 2 years preferred
- CCS preferred
- RHIT preferred
Schedule & Work Environment
- Remote position
- Flexible scheduling opportunities
- Full-time and contract opportunities available depending on client needs
Benefits
- Flexible schedule
Location
N/A
Employment Type
Not specified
Experience Level
Intermediate Level
Remote work allowed
Yes
Posted
1 month ago