Certified Medical Coder - Surgical Services

About the role

Integrative Emergency Services (“IES”) LLC is a physician founded, owned, and led company whose goal is to empower physician leaders to create the best places to give and receive care. They are a clinically integrated and outcomes-based organization committed to doing the right thing for clinicians, patients, and communities. IES is seeking a Certified Medical Coding Specialist with emphasis on surgical services. Both AAPC or AHIMA certifications are acceptable. A Surgical related coding certification such as the CGSC, CASCC, CCVTC or a CPMA certification would be a plus. The Medical Coding Specialist is responsible for accurate professional fee coding and documentation review for assigned surgical service lines (URSA / NTCC / TSN). This role evaluates medical records to ensure proper CPT, HCPCS Level II, and ICD-10-CM code assignment in accordance with payer guidelines and regulatory standards. This role supports documentation integrity, identifies coding compliance risks (including undercoding, overcoding, and unbundling), and contributes to clean claim submission and optimal reimbursement through coding analysis, audits, and special projects. This role would support multiple surgical practices we have, primarily found in the Dallas-Fort Worth area. Candidates can work in either a hybrid or remote setting. If remote, must reside in a state IES operates in: AZ, CO, TX, OK, IN, MO, AL, SC, FL.

Responsibilities

• Accurately assign CPT, ICD-10-CM, and HCPCS Level II codes for professional surgical services based on thorough medical record review.
• Evaluate medical records for proper code assignment, completeness, accuracy, and support of medical necessity.
• Ensure coding compliance with CMS, commercial payer, and regulatory guidelines.
• Identify and address undercoding, overcoding, modifier misuse, and unbundling issues.
• Apply appropriate modifiers and ensure correct provider, place of service, and payer selection.
• Conduct claim review to support clean claim submission and reduce denials.
• Audit coding accuracy through ad hoc reports, focused reviews, and special projects.
• Analyze coding-related denials and recommend corrective actions.
• Review payer policies and stay current on annual coding updates and regulatory changes.
• Collaborate with providers and operational leadership to clarify documentation and improve coding specificity.
• Maintain productivity and quality benchmarks established by the department.
• Serve as a subject matter resource for surgical coding guidance within assigned service lines.

Qualifications

• High school diploma or equivalent.
• Minimum five (5) years of professional medical coding experience.
• Strong surgical coding experience required.
• Active coding certification through: American Academy of Professional Coders (AAPC) (ie. CPC), or American Health Information Management Association (AHIMA) (ie. CCS).
• Preferred: Specialized coding certification such as CGSC (General Surgery), CASCC (Ambulatory Surgery), CCVTC (Cardio Thoracic Surgery) or a CPMA (Auditing).
• Experience conducting internal coding audits.
• Experience with CMS Part B and commercial payer reimbursement methodologies.

Skills

• High-level knowledge of general surgery-related medical terminology, anatomy, and pathophysiology.
• Strong understanding of CPT procedure coding, HCPCS Level II procedure and supply codes, and ICD-10-CM diagnosis coding.
• Knowledge of coding in surgical practices, ambulatory surgery centers, and hospital settings.
• Ability to evaluate documentation for medical necessity and coding compliance.
• Strong understanding of National Correct Coding Initiative (NCCI) edits and bundling guidelines.
• Ability to audit reports, conduct focused reviews, and participate in special projects.
• Advanced analytical and problem-solving skills