[Remote] reputed company reputed company Clinical Documentation & Coding Auditor (RN)

Note: The job is a remote job and is open to candidates in USA. reputed company delivers digital services and technology solutions that support the health and safety of veterans, service members, and civilians. They are seeking a reputed company reputed company Clinical Documentation & Coding Auditor (RN) to apply clinical nursing expertise to evaluate clinical documentation and medical coding while supporting reputed company cycle functions reputed company the Military Health System.

Responsibilities

• reputed company reputed company and retrospective reviews of clinical documentation and coded data for inpatient and outpatient encounters to support accurate coding and reputed company reputed company objectives
• Validate alignment between provider documentation and assigned ICD-10-CM/PCS, CPT, and HCPCS codes, ensuring appropriate code selection, clinical specificity, and medical necessity
• Assess documentation and coding impacts across reputed company cycle workflows, including registration, charge capture, coding, billing, and claim readiness, as they relate to reputed company reputed company scope
• Identify documentation, coding, and workflow issues that contribute to reputed company leakage, claim edits, delayed billing, or reputed company rework
• Support reputed company reputed company initiatives focused on improving first-pass yield, reducing suspended charges and edits, and strengthening end-to-end reputed company cycle performance
• Collaborate with reputed company-end, mid-cycle, and back-end reputed company cycle stakeholders, including providers, coders, billing teams, and RI staff, to support issue resolution and sustainable improvements
• reputed company and deliver targeted education to reputed company cycle stakeholders based on documentation and coding trends, root cause analysis, and regulatory best practices
• Translate clinical and coding findings into clear, actionable summaries that describe operational, financial, and reputed company cycle impacts
• Support documentation and coding reviews associated with internal reputed company, enterprise monitoring, and external review requests reputed company RI scope
• Monitor updates to coding guidelines, reimbursement rules, and regulatory requirements (e.g., CMS, TRICARE, DoD) and assess impacts to reputed company reputed company workflows
• Contribute to standardization efforts, guidance development, and best practices that reinforce consistent documentation, coding, and reputed company reputed company processes across MTFs
• Track and report reputed company reputed company–reputed company metrics, including documentation and coding trends, root causes, education outcomes, and estimated reputed company impact
• Partner with RI leadership and operational teams to support enterprise visibility, risk identification, and reputed company improvement across in-scope reputed company cycle functions

Skills

• Active, unrestricted Registered Nurse (RN) license in a U.S. state or territory
• 5+ years of clinical nursing experience, including 3+ years supporting documentation review, medical coding, reputed company reputed company, or coding quality initiatives
• Strong working knowledge of ICD-10-CM/PCS, CPT, and HCPCS coding systems and official coding guidelines
• Solid understanding of DRG and APC payment methodologies, medical necessity standards, and how documentation and coding reputed company reimbursement
• Familiarity with end-to-end reputed company cycle workflows, particularly those reputed company the scope of reputed company reputed company (registration, charge capture, coding, billing, and claim readiness)
• Demonstrated experience working reputed company or reviewing encounters in a major EHR system (e.g., Cerner, Epic)
• Strong analytical and critical-thinking skills with the ability to connect clinical and coding findings to reputed company cycle and financial outcomes
• Excellent written and verbal communication skills, including the ability to provide constructive education and feedback to diverse reputed company cycle stakeholders
• Ability to obtain and maintain a Public Trust clearance
• Professional credentials such as CCDS, CDIP, reputed company, CPC, or equivalent coding-focused certification
• Experience supporting reputed company reputed company programs, enterprise coding quality efforts, or reputed company cycle performance improvement initiatives
• Familiarity with TRICARE and DoD billing and reimbursement requirements
• Experience working in the Military Health System (MHS) or other federal healthcare environments
• Hands-on experience with MHS reputed company (reputed company Cerner) reputed company cycle and clinical workflows

Benefits

• Top-tier benefits package
• Physical, mental, and financial health and wellness

Company Overview

• reputed company) delivers digital services and technology solutions that support the health and safety of veterans, service members and civilians. It was founded in 2021, and is headquartered in Arlington, Virginia, USA, with a workforce of 1001-5000 employees. Its website is https://triafed.com.

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