We are seeking an experienced Clinical Coding & Data Quality Analyst to support healthcare data accuracy, standardization, and integrity across a variety of analytics and reporting initiatives. This role will serve as a subject matter expert in clinical coding systems, classification methodologies, and healthcare data quality, helping ensure that complex clinical and financial data is accurate, consistent, and compliant with regulatory standards.

The ideal candidate brings a strong background in ICD-10-CM, ICD-10-PCS, CPT, and HCPCS coding, along with experience in charge mapping, data classification, coding audits, and healthcare data quality improvement. This individual will work closely with internal teams and external healthcare partners to identify data discrepancies, improve mapping accuracy, implement coding updates, and establish best practices for standardized data collection and reporting.

Key Responsibilities

• Serve as a subject matter expert in ICD-10-CM, ICD-10-PCS, CPT, and HCPCS coding systems and official coding guidelines.
• Support the development, maintenance, and optimization of clinical transaction classification and charge code systems.
• Review and improve hospital charge-to-classification mappings to ensure accuracy, consistency, and completeness.
• Monitor regulatory updates, coding changes, and terminology revisions, communicating impacts to relevant stakeholders.
• Identify gaps in terminology mapping and recommend enhancements to improve healthcare data standardization.
• Provide coding guidance, education, and best practices to internal teams and external healthcare partners.
• Collaborate with cross-functional teams on coding initiatives, data integrity, and classification improvements.
• Support healthcare data acquisition processes, ensuring timely, accurate, and complete data submissions from participating hospitals.
• Perform remapping activities to correct misclassified or legacy charges and align them with updated classification codes.
• Investigate root causes of coding-related data quality issues and develop actionable recommendations for resolution.
• Lead and support data quality improvement initiatives related to coding, classification, and healthcare data.
• Develop tools, resources, and procedures to improve data submission processes and coding-related workflows.
• Respond to stakeholder inquiries related to coding, healthcare data, data submissions, and research initiatives.

Qualifications & Experience

• Bachelor’s degree in Health Informatics, Health Information Management, or a related field.
• Minimum of 5 years of professional healthcare experience, with significant experience in clinical coding, classification systems, and/or healthcare data quality improvement.
• Expert knowledge of ICD-10-CM, ICD-10-PCS, CPT, HCPCS, and official coding guidelines.
• Strong understanding of clinical classification systems, including ICD-9/10, MS-DRG, APR-DRG, severity of illness (SOI), risk of mortality (ROM), and healthcare quality measures.
• Strong knowledge of medical terminology, clinical workflows, and healthcare data, including administrative, billing, and clinical information.
• Experience with coding audits, Clinical Documentation Integrity (CDI), revenue integrity initiatives, or charge description master maintenance preferred.
• Experience supporting enterprise systems, healthcare applications, and data platforms.
• Background developing and maintaining data dictionaries and standardizing data collection, quality, and analysis processes.
• Familiarity with electronic health record (EHR) systems and data analysis tools.
• Understanding of healthcare data security and HIPAA requirements.
• Strong analytical, problem-solving, and communication skills, with the ability to investigate complex data discrepancies and recommend solutions.

Preferred Certifications

One or more of the following certifications are strongly preferred:

• RHIA – Registered Health Information Administrator
• CCS – Certified Coding Specialist
• CCS-P – Certified Coding Specialist–Physician-based
• CPC – Certified Professional Coder
• CHDA – Certified Health Data Analyst
• CDIP – Certified Documentation Integrity Practitioner
• CCDS – Certified Clinical Documentation Specialist

What Makes This Opportunity Interesting

This is an excellent opportunity for a healthcare coding and informatics professional who enjoys working at the intersection of clinical coding, healthcare analytics, and data quality. The role offers the opportunity to influence data standardization practices, improve the accuracy of healthcare reporting, collaborate with industry professionals, and contribute to meaningful data quality initiatives.

Hybrid Work Schedule 

About Us

Hunter Hamilton is a high-performance professional search firm specializing connecting finance, HR, operations, and legal talent with leading employers.

Hunter Hamilton is an equal opportunity employer. All applicants will receive consideration without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status, or any other legally protected status. Hunter Hamilton offers reasonable accommodations for qualified individuals with disabilities; contact your local branch for inquiries. Hunter Hamilton is an E-Verify employer. See our Privacy Notice for Candidates and Employees/Contractors at https://smgroupna.com/privacy-notice-for-candidates-and-employees-contractors. By applying, you consent to receive AI-generated and non-AI-generated calls, texts, or emails from Staffmark Group, its affiliates, and partners. Frequency varies and message/data rates may apply. Reply STOP to cancel or HELP for help.