Analyst, Healthcare Medical Coding - Disputes, Claims & Investigations

Impact You’ll Make

This section outlines the key outcomes and contributions expected from the role. It highlights how your work will shape engagements, support clients, and drive value across Stout’s Healthcare Consulting practice.

Contribute to complex healthcare consulting engagements involving coding audits, disputes, claims analysis, and investigations.

Deliver high-quality, accurate coding analysis that informs client decisions, regulatory responses, and litigation support.

Identify risks related to billing, coding, and reimbursement, including potential fraud, waste, and abuse.

Support the development of defensible findings and recommendations through detailed documentation and analysis.

Enhance Stout’s reputation for excellence by applying deep expertise in inpatient coding, reimbursement systems, and compliance.

What You’ll Do

• Perform detailed reviews of inpatient medical records to assess accuracy of ICD-10-CM/PCS coding and alignment with clinical documentation.
• Analyze coding, billing, and reimbursement practices across engagements involving audits, disputes, and investigations.
• Support forensic analyses to identify compliance risks, inefficiencies, and reimbursement discrepancies.
• Audit, regulatory reviews, and litigation support by gathering evidence, analyzing issues, and contributing to reporting.
• Evaluate DRG/APR-DRG/APC assignments and reimbursement implications based on clinical documentation.
• Collaborate with internal teams, clients, and legal counsel to support engagement objectives.
• Prepare clear, well-structured reports, analyses, and client-ready deliverables summarizing findings and recommendations.
• Monitor coding trends, denials, billing edits, and regulatory updates to inform analyses and engagement insights.

What You Bring

• Bachelor’s degree in Health Information Management or related field (or equivalent experience).
• Minimum of five (5) years of recent acute-care inpatient facility coding experience.
• Strong experience with DRG and PCS coding, including auditing; denials experience preferred.
• Active coding credential required (CCS, CIC, RHIT, or RHIA).
• Knowledge of MS-DRG, APR-DRG, APC methodologies and reimbursement frameworks.
• Familiarity with healthcare regulatory frameworks (e.g., CMS, HIPAA, False Claims Act).
• Proficiency in Microsoft Office (Excel, Word, PowerPoint); experience with data visualization tools is a plus.
• Strong analytical, problem-solving, and written/verbal communication skills.

How You’ll Thrive

• Analytical and Detail-Oriented: Ability to interpret complex clinical and coding data and draw well-supported conclusions.
• Collaborative and Client-Focused: Works effectively with cross-functional teams and builds strong client relationships.
• Accountable and Proactive: Takes ownership of work, manages priorities, and delivers high-quality results on time.
• Adaptable and Curious: Thrives in a fast-paced consulting environment and continuously learns new regulations and methodologies.
• Quality and Integrity Driven: Demonstrates commitment to ethical coding practices and compliance standards.
• Aligned with Stout Values: Embodies Relentless Excellence® through teamwork, responsiveness, and strong communication.

Why Stout?

At Stout, we offer a comprehensive Total Rewards program with competitive compensation, benefits, and wellness options tailored to support employees at every stage of life. We foster a culture of inclusion and respect, embracing diverse perspectives and experiences to drive innovation and success. Our leadership is committed to inclusion and belonging across the organization and in the communities we serve. We invest in professional growth through ongoing training, mentorship, employee resource groups, and clear performance feedback, ensuring our employees are supported in achieving their career goals. Stout provides flexible work schedules and a discretionary time off policy to promote work-life balance and help employees lead fulfilling lives.

Learn more about our benefits and commitment to your success.