Facility Coding Inpatient DRG Quality Analyst

Estimated Pay Range: $29.11 - $48.51 / hour, based on location, education, & experience. In accordance with State Pay Transparency Rules.

Department Name: Coding-Acute Care Compl & Educ

Work Shift: Day

Job Category: Revenue Cycle

Banner Health recently earned Great Place To Work® Certification™. This recognition reflects our investment in workplace excellence and the happiness, satisfaction, wellbeing and fulfillment of our team members.

In this Inpatient Facility-based HIMS Coding Quality Associate position you bring your 5 years of acute care inpatient coding background to a team that values growth and development. This is a quality position, not a day‑to‑day coding production role but requires coding proficiency and recent hospital facility coding experience.

Schedule: Full time, Monday–Friday 8 am–5 pm during training. Flexible scheduling after completion of training.

Location: REMOTE, Banner provides equipment.

• 5 years recent experience in acute‑care inpatient facility‑based medical coding; clearly reflected in your attached resume.
• DRG and PCS coding, auditing experience.
• Bachelor’s degree or equivalent.
• Certified through AAPC or AHIMA; upload a copy or provide certification number.

This is a fully remote position and available to residents in the following states only:

• AK
• AR
• AZ
• CA
• CO
• FL
• GA
• IA
• IN
• KS
• KY
• MI
• MN
• MO
• MS
• NC
• ND
• NE
• NM
• NV
• NY
• OH
• OK
• OR
• PA
• SC
• TN
• TX
• UT
• VA
• WA
• WI
• WY

This position is responsible for the interpretation of clinical documentation completed by the health care team for the health record(s) and for quality assurance in the alignment of clinical documentation and billing codes. Works with clinical documentation improvement and quality management staff to align diagnosis coding to documentation, improve quality of clinical documentation, and ensure correctness of billing codes prior to claim submission.

The candidate will also identify opportunities for improvement of clinical documentation and accurate MS‑DRG, APC, or ICD‑10 assignments on health records, and provide guidance on experimental and newly developed procedure and diagnostic coding.

• Provides guidance on coding and billing using guidelines, demonstrating extensive knowledge of clinical documentation and its impact on reimbursement under Medicare Severity Adjusted System (MS‑DRG), All Payer Group (APR‑DRG) and Ambulatory Payment Classification (APC).
• Reviews medical records, audits clinical documentation, and ensures coding accuracy for proper reimbursement. Provides feedback on coding work and trends and suggests improvements. Applies UHDDS definitions where applicable and follows policies and procedures consistent with official coding guidelines.
• Maintains consistency in coding practices, follows through on physician queries to ensure accurate code assignment, identifies training needs for coding staff, and participates in internal coding accuracy audits.
• Acts as a knowledge resource to ancillary clinical departments, patient financial services, and revenue integrity analysts regarding charge related issues, processes and programming. Participates in company‑wide quality teams’ initiatives to improve coding and clinical documentation, and assists in education and training of staff.
• Performs ongoing audits or reviews of inpatient and/or outpatient medical records to ensure proper diagnostic and procedure code assignments. Collaborates on DRG and coding denials, billing edits and rejections to provide coding expertise, support reimbursement and develop coding education plans.
• Maintains current knowledge of coding regulatory updates and software used for coding, reviews and analyses trends in DRG, APC, HCC and other risk adjustment factors.
• May code inpatient and outpatient records as needed and works with the HIMS team to achieve goals in days‑to‑bill.
• Works independently under limited supervision, providing expert coding and billing guidance to all Banner facilities and services. Internal customers include medical staff, employees, and management; external customers include practicing physicians, vendors and the community.

• Bachelor’s degree in Health Information Management or equivalent experience.
• Fiv…