IRF Coding Specialist

Job Overview

Ocean Health Executives is seeking an experienced and detail-oriented Inpatient Rehabilitation Facility (IRF) Coder to join our growing coding and compliance team. The IRF Coder will be responsible for concurrent review of inpatient rehabilitation medical records, assignment of accurate ICD-10-CM diagnosis codes, validation of IRF-PAI data, and support of compliant reimbursement under the Medicare IRF Prospective Payment System (PPS).

This role requires a strong understanding of IRF coding guidelines, rehabilitation documentation requirements, Case-Mix Group (CMG) assignment, comorbid condition review, and collaboration with clinical and CDI teams to ensure coding accuracy and regulatory compliance.

Responsibilities

• Perform concurrent and retrospective coding review for inpatient rehabilitation encounters
• Assign accurate ICD-10-CM diagnosis codes in accordance with Official Coding Guidelines and payer-specific requirements
• Review and validate IRF-PAI documentation and coding elements impacting CMG assignment and reimbursement
• Identify and validate comorbid conditions, complications, and tier-impacting diagnoses
• Review physician documentation for completeness, specificity, and coding support
• Communicate documentation clarification opportunities to providers and CDI teams as appropriate
• Ensure coding accuracy, compliance, and timely completion of assigned work queues
• Maintain productivity and quality standards established by the organization and client
• Participate in internal QA reviews, education sessions, and coding updates
• Collaborate with coding leadership, CDI specialists, and operational teams to resolve coding and documentation issues
• Maintain current knowledge of CMS regulations, IRF PPS updates, ICD-10-CM coding changes, and rehabilitation documentation requirements

Qualifications

• Minimum 3–5 years of inpatient coding experience required
• Minimum 1–2 years of IRF coding experience strongly preferred
• Strong knowledge of:
• IRF Prospective Payment System (PPS)
• IRF-PAI review and validation
• ICD-10-CM coding guidelines
• Rehabilitation documentation requirements
• Medicare regulations and compliance standards
• Experience performing concurrent review preferred
• Familiarity with Epic or other electronic medical record systems preferred
• Strong analytical, organizational, and communication skills
• Ability to work independently in a remote environment
• Must maintain strict confidentiality and HIPAA compliance

Required Credentials

One or more of the following credentials required:

• AHIMA Certified Coding Specialist (CCS)
• AHIMA Registered Health Information Administrator (RHIA)
• AHIMA Registered Health Information Technician (RHIT)

Preferred Experience

• IRF concurrent coding and review
• IRF-PAI auditing or validation
• CDI collaboration
• Medicare rehabilitation reimbursement methodologies
• Remote coding production environments
• Quality auditing experience

Schedule \& Work Environment

• Remote position
• Flexible scheduling opportunities
• Full-time and contract opportunities available depending on client needs

Why Join Ocean Health Executives?

Ocean Health Executives offers a collaborative environment focused on coding quality, compliance excellence, and operational innovation. Our team is composed of experienced coding and HIM professionals dedicated to supporting healthcare organizations nationwide through accurate, compliant, and efficient coding services.

Pay: $32\.00 - $44\.00 per hour

Benefits:

• Flexible schedule

Experience:

• IRF coding: 2 years (Preferred)

License/Certification:

• CCS (Preferred)
• RHIT (Preferred)

Work Location: Remote