Coding Liaison

3 weeks ago


Detroit, Michigan, United States R1 RCM Full time

R1 is the leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry's most advanced technology platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration.

As our Coding Liaison, you will provide an advanced level of coding review related to potential coding quality concerns at the request of customer leadership (CFO, Clinical Directors, CCO, CMO and others). The Coding Liaison reviews complex inquiries related to ICD-10, CPT, DRG/APR-DRG or APC codes. Every day you will collaborate with the following R1 teams: Quality, Coding, Education and Training Teams, Revenue Integrity, CDM and PFS/Site Leaders. The coding liaison team is the primary contact and resource for site customers including CDI, Quality/Risk, Case Management, Patient Advocate's, Physician Advisors, Clinical Departments and Administration. To Thrive in this role the coding liaison needs intermediate skill level in Microsoft Word, Excel, PowerPoint, Outlook, strong communication and presentation skills and the ability to interact professionally with other associates, department directors and the medical staff through effective verbal and written communication. The coding liaison needs strong analytical and research skills, ability to review complex medical records, possess good project management and problem-solving skills, have the ability to prioritize, multitask, work in a fast-paced, high-volume environment while demonstrating critical thinking skills, strong leadership qualities, and good decision-making abilities. The coding Liaison should have Advanced knowledge of ICD-10/CPT coding systems and guidelines.

Please be advised, this is a full time, remote role with the coding liaison working Monday through Friday. A RHIA or RHIT certification, associates or bachelor's degree in HIM or other field is preferred but not required. Experience working with the CDI team is preferred but not required. Inpatient or Outpatient audit experience is preferred but not required.

Here is what you will experience working as Coding Liaison:

  • Completing requests from customers and collaborative partners noted above to determine if coding quality issues exist. Review results are shared with Local and Regional Coding Site managers, Coding Advisory team and R1 Education and Training team as needed when coding issues are identified
  • Recovering potential lost revenue through coding reviews related to medical necessity, DRG assignment, charges etc.
  • Performing escalated coding reviews (second level) related to DRG mismatch, medical necessity edits, CPT mismatch, inpatient only CPT, PSI, POA etc.
  • Identifying trended coding quality issues requiring new or refresher coder education for accurate and compliant code, DRG/APR-DRG, APC assignment
  • Partnering with the Quality & Risk teams to perform coding reviews related to CMS Quality & Patient Safety initiatives
  • Collaborating with the CDI team, assisting with the resolution of documentation inconsistencies and DRG variances
  • Educating the CDI team and Physician Advisor on coding changes, DRGs, Official coding guidelines and documentation requirements
  • Providing coding education/guidelines to Quality and Risk, related to HAC, PSI, Mortalities, Core Measures and all other CMS reporting related to pay for performance
  • Attending various meetings to include CDI/Mortality/PSI/Revenue Integrity/R1 Coding Quality as needed

Required Qualifications:

  • 5 years of inpatient coding experience
  • CCS Certification

For this US-based position, the base pay range is $ $41.68 per hour . Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training.

The healthcare system is always evolving — and it's up to us to use our shared expertise to find new solutions that can keep up. On our growing team you'll find the opportunity to constantly learn, collaborate across groups and explore new paths for your career.

Our associates are given the chance to contribute, think boldly and create meaningful work that makes a difference in the communities we serve around the world. We go beyond expectations in everything we do. Not only does that drive customer success and improve patient care, but that same enthusiasm is applied to giving back to the community and taking care of our team — including offering a competitive benefits package. )

R1 RCM Inc. ("the Company") is dedicated to the fundamentals of equal employment opportunity. The Company's employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person's age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, the Company is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories.

If you have a disability and require a reasonable accommodation to complete any part of the job application process, please contact us at for assistance.

CA PRIVACY NOTICE: California resident job applicants can learn more about their privacy rights California Consent )

To learn more, visit:

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#LI -TJ01 #TJ2022 #LI-Remote #Healthcare

R1 is the leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry's most advanced technology platform, encompassing sophisticated analytics, AI, intelligent automation and workflow orchestration.

Headquartered near Salt Lake City, Utah, R1 employs over 29,000 people globally and is traded on the Nasdaq stock exchange under the symbol "RCM."




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