Senior HIM & Coding Consultant

Description

PCG Consulting International partners with healthcare organizations to solve complex operational, technology, and business challenges that improve financial performance and patient care.

PCG Consulting Group is seeking an experienced Senior HIM & Coding Consultant to support a large-scale hospital revenue recovery and operational stabilization initiative. This consultant will provide expertise in Health Information Management (HIM), clinical documentation, medical coding, and revenue cycle operations to help restore accurate billing and reimbursement.

Working alongside Revenue Cycle Consultants, Data Architects, Patient Financial Services, and technical teams, the Senior HIM & Coding Consultant will validate clinical documentation, assess coding accuracy, support claim reconstruction, and identify opportunities to improve documentation and reimbursement processes.

Key Responsibilities

• Review clinical documentation to ensure coding accuracy and billing compliance.
• Evaluate ICD-10-CM, ICD-10-PCS, CPT, and HCPCS coding practices.
• Assess documentation quality and identify coding gaps affecting reimbursement.
• Support claim reconstruction by validating coded encounters and supporting documentation.
• Collaborate with HIM, Coding, Clinical Documentation Integrity (CDI), Revenue Integrity, and Patient Financial Services teams.
• Review denied claims and identify documentation or coding issues contributing to payment delays.
• Recommend process improvements that enhance coding accuracy and revenue cycle performance.
• Assist with documentation audits and coding validation efforts.
• Produce findings and recommendations for project leadership.

Engagement Details

• Project-Based W2 Consulting Position
• Primarily Remote
• Occasional onsite meetings in the Chicago metropolitan area as project needs require.
• Several-month engagement with the potential for extension.

Why Join PCG Consulting Group?

Join an experienced consulting team supporting one of the Chicago area's most significant hospital revenue recovery initiatives. You'll work alongside healthcare leaders and technical experts to improve documentation quality, coding accuracy, and financial performance while helping restore critical hospital operations.

Requirements

7+ years of Health Information Management (HIM) and hospital coding experience.

• Extensive knowledge of:
  • ICD-10-CM
  • ICD-10-PCS
  • CPT
  • HCPCS
  • MS-DRGs
  • APCs
• Strong understanding of hospital revenue cycle operations and reimbursement methodologies.
• Experience with Clinical Documentation Improvement (CDI) initiatives.
• Experience working with acute care hospitals or integrated health systems.
• Strong analytical, communication, and documentation skills.

Preferred Qualifications

• RHIA, RHIT, CCS, CCS-P, CPC, or other HIM/coding certifications.
• Experience with revenue cycle optimization or recovery initiatives.
• Experience with hospital EHR platforms such as Paragon, Epic, Cerner, or Meditech.
• Healthcare consulting experience.
• Knowledge of Revenue Integrity and coding compliance.