Remote Risk Analyst Jobs in Fort Mill, SC (NOW HIRING)

Major Responsibilities:

• Deliver proactive coding education through newsletters, scorecards, and presentations, covering CPT (E&M, modifiers), ICD-10-CM, HCPCS, Risk Adjustment, payer requirements, and rejection resolutions.

• Lead onboarding and compliance training for all employed Physicians/APPs, including Locum Tenens, residents, and students, ensuring documentation accuracy from the start.

• Provide individualized documentation feedback by reviewing new clinician records and conducting spot checks, escalating non-coding issues to appropriate teams.

• Serve as the primary contact for coding inquiries, coordinating with internal teams to resolve complex issues such as NCCI bundling and high-complexity charge edits.

• Monitor Epic work queues (charge review, follow-up, claim edit) to ensure timely and accurate charge submissions and reduce claim denials.

• Collaborate across departments-including CMOs, Clinical Informatics, Risk Adjustment, and Population Health-to enhance documentation practices and system optimization.

• Participate in specialty and department meetings, identifying trends and delivering targeted education to improve coding and documentation accuracy.

• Refine Epic documentation tools, including templates, order entries, diagnosis lists, and SmartSets/SmartPhrases, to improve efficiency and accuracy.

• Ensure compliance with regulatory standards, including Medicare, Medicaid, and AHIMA's Standards of Ethical Coding, while maintaining expert knowledge of evolving policies.

• Promote a culture of ethical coding and continuous improvement, supporting clinicians with timely updates, feedback, and education to ensure accurate reimbursement and compliance.

Licensure, Registration, and/or Certification Required:

• Registered Health Information Administrator (RHIA) or

• Registered Health Information Technician (RHIT) certification, or

• Coding Specialist (CCS) certification, or Coding Specialist -Physician (CCS-P) certification issued by the American Health Information Management Association (AHIMA) or

• Professional Coder (CPC) certification issued by the American Academy of Professional Coders (AAPC).

• Additional specialty credential preferred.

Education Required:

• Completion of advanced training through a recognized or accredited program, equivalent in scope and rigor to post-secondary education or equivalent knowledge. High school diploma or GED required.

Experience Required:

• Typically requires 4 years of experience in expert-level professional coding.

Knowledge, Skills & Abilities Required:

• Advanced Coding Expertise: In-depth knowledge of ICD, CPT, and HCPCS coding guidelines, ensuring accurate and compliant coding practices.

• Medical Terminology & Anatomy: Strong understanding of medical terminology, anatomy, and physiology to support precise code assignment.

• Epic & Reporting Solutions: Advanced knowledge of Epic and other reporting tools to analyze data, generate reports, and optimize workflow efficiencies.

• Critical Thinking & Analytical Skills: Highly proficient in problem-solving and analytical thinking with strong attention to detail.

• Interpersonal Communication: Excellent verbal and written communication skills, with the ability to educate and collaborate effectively with physicians, APCs, clinical leadership, and coding teams.

• Advanced Computer Skills: Proficiency in Microsoft Office Suite, electronic coding applications, and email communication.

• Organizational & Prioritization Skills: Ability to efficiently manage multiple tasks, set priorities, and meet deadlines in a fast-paced environment.

• Independent Decision-Making: Ability to work independently, exercise sound judgment, and make informed decisions regarding coding and compliance.

• Collaboration & Initiative: Strong ability to take initiative, contribute to process improvements, and work collaboratively within a team environment.

Physical Requirements and Working Conditions:

• Follow organizational and divisional remote work policy and guidelines.

• Operates all equipment necessary to perform the job.

• Handles a fast paced and creative work environment moving independently from one task to another.

• Makes sound decisions within limited time frames and always conducts business in a professional manner and has demonstrates ability to work cooperatively and effectively with others on an individual and team basis.

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.

#REMOTE

#LI-REMOTE