Coding Quality Analyst

Coding Quality Analyst

Schedule: Monday–Friday, 8-hour shifts scheduled anytime between 6:00 AM–6:00 PM EST
Pay Rate: $21/hr (Paid Weekly)
Allmed Benefits: Dental, Health, Vision Insurance and 401(k)
Position Type: Full-Time / 40/hr per wk
Work Location: Remote
Contract: 09/14/2026 to 02/22/2027
Interview: 1 round, video interview, approximately 30 minutes

Position Overview

The Coding Quality Analyst is responsible for reviewing medical records, extracting relevant clinical and coding information, and developing accurate, strongly supported appeal letters on behalf of clients. This role combines inpatient and outpatient coding expertise, critical thinking, medical record analysis, and strong written communication skills.

The Coding Quality Analyst will use established coding guidelines, clinical information, and evidence-based medical literature to support accurate and defensible appeals while ensuring appropriate DRG assignment and coding accuracy. The position requires an independent, self-directed professional who can work effectively in a fast-paced and continuously evolving environment.

Key Responsibilities

• Review patient medical records and accurately extract pertinent clinical and coding information.
• Analyze medical records to identify opportunities related to coding and DRG assignment.
• Develop clear, accurate, and strongly defensible appeal letters following departmental and company guidelines.
• Apply knowledge of ICD-9, ICD-10-CM, ICD-10-PCS, CPT, and HCPCS coding systems.
• Utilize encoder tools and applicable coding guidelines to support accurate coding decisions.
• Interpret and apply AHA Coding Clinic guidance for ICD-9 and ICD-10.
• Select appropriate and supportable appeal arguments using provided evidence-based, peer-reviewed medical literature.
• Recommend coding changes that may retain, lessen, or increase financial impact when supported by medical record analysis.
• Educate clients regarding appropriate coding, compliance, and coding best practices.
• Participate in Administrative Law Judge (ALJ) hearings as a client representative during tele-hearings, when applicable.
• Complete assigned cases within established turnaround expectations while maintaining a high level of quality and accuracy.
• Independently review completed appeals to ensure accuracy, thoroughness, and appropriate supporting documentation before finalizing cases.
• Collaborate with physicians, Appeals leadership, Operations, Intake, and other internal departments.
• Work independently while utilizing guidance and direction provided by Appeals leadership.

Required Qualifications

• Coding certification required.
• Inpatient hospital coding experience.
• Mastery-level knowledge of AHA Coding Clinics for ICD-9 and ICD-10.
• Experience with DRG methodology.
• Experience with outpatient coding.
• Medicare and Medicaid coding experience.
• Strong and effective written communication skills.
• Strong critical-thinking and analytical abilities.
• Ability to work independently in a fast-paced environment.
• Strong computer proficiency.
• Proficiency with Microsoft Word.

Preferred Qualifications

• Active RN license (NOT required)
• Experience presenting before an Administrative Law Judge (ALJ).
• Auditing experience.

Ideal Candidate

The ideal candidate is a highly detail-oriented coding professional with strong inpatient hospital coding experience and a deep understanding of coding guidelines and DRG methodology. The successful candidate will be comfortable analyzing complex medical records, developing well-supported written appeals, and making coding recommendations based on documented evidence.

This individual should be self-directed, organized, highly accurate, and able to balance productivity with quality while working independently in a remote environment.