Coding Specialist-I

About The Role The Coding Specialist I is responsible for independently reviewing, analyzing, and resolving all assigned front-end claims to ensure accurate and timely claim submission. This position focuses on identifying and correcting coding-related issues prior to claim transmission, applying established coding guidelines, payer requirements, and organizational policies. The Coding Specialist I works closely with revenue cycle partners to prevent claim rejections, support clean claim rates, and promote efficient reimbursement processes. This role requires strong attention to detail, foundational coding knowledge, and the ability to work independently in a fast-paced environment. A Day in the Life Averages 10 front-end holds per hourMaintains a minimum of 90% coding accuracyAssigns ICD-10-CM and CPT codes with appropriate modifiers for services provided in the professional fee environmentReviews medical records and all applicable documentation to determine appropriate codes for documented services and diagnosesEnsures all diagnosis codes meet local and national medical necessity guidelinesUtilizes internal coding resources, payer guidelines, and other reference materials to ensure accurate and compliant coding for all assigned servicesFollows all HIPAA regulations and upholds the highest standards of privacy and confidentialityMaintains current knowledge of laws, regulations, payer policies, and industry guidance impacting compliant coding practicesIndependently reviews and resolves all assigned front-end claim holdsActively participates in department meetings, one-on-one meetings, and mentorship meetings with the assigned Coding Team LeadEscalates identified client trends to the assigned Coding Team LeadEscalates all coding-related questions to the assigned Coding Team Lead for guidance and clarificationMaintains and completes all CEU requirementsPerforms other duties or tasks as assigned What You Need Must hold a current AAPC or AHIMA Certification for a minimum of 3 yearsStrong working knowledge of CPT, ICD-10-CM, medical terminology, anatomy and physiology, and state and federal Medicare reimbursement guidelinesFamiliarity with proper English grammar, usage, and professional documentation standardsAbility to research and analyze data, draw logical conclusions, and resolve coding or documentation issuesAbility to read, interpret, and apply policies, procedures, laws, and regulationsAbility to accurately read and interpret medical documentation, clinical terminology, and documented proceduresDemonstrated ability to exercise independent judgment in coding and claim resolutionExcellent written and verbal communication skills, including the ability to prepare reports, clarify documentation needs, and maintain collaborative working relationships with physicians and staffStrong commitment to maintaining confidentiality and safeguarding protected health informationPrior experience working in a medical billing environment with strict adherence to HIPAA compliance requirementsDemonstrated proficiency in Microsoft Office Suite (Word, Excel, Outlook, Teams)Minimum of 3+ years of professional coding experience We offer competitive benefits to set you up for success in and outside of work. Here's What We Offer Generous Paid Time Off: Recharge and relax with 20 days of fixed time off per year, in addition to company holidays—because we believe work-life balance fuels performanceBest-in-Class Parental Leave: Spend quality time with your growing family. We offer one of the industry's most generous parental leave policies to support you during life's most important momentsRecognition & Rewards: We celebrate wins—big and small. Get rewarded with monetary incentives and company-wide recognition for your impact and dedication. Your hard work won't go unnoticedComprehensive Insurance Coverage: Stay covered with medical, dental, and vision insurance, plus 100% company-paid short- and long-term disability and basic life insurance. Optional perks include discounted legal aid and pet insurance Innovaccer Inc. is an equal opportunity employer. We celebrate diversity and are committed to fostering an inclusive workplace where all employees feel valued and empowered regardless of any characteristic protected by federal, state or local law including, without limitation, race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, medical condition, disability, age, marital status, or veteran status. Innovaccer Inc. participates in the E-Verify program to confirm employment eligibility of all newly hired employees based out of the U.S. and employed by Innovaccer Inc. For any additional information, please visit the below websites: E-Verify Right to Work (English) Right to Work (Spanish) Disclaimer: Innovaccer does not charge fees or require payment from individuals or agencies for securing employment with us. We do not guarantee job spots or engage in any financial transactions related to employment. If you encounter any posts or requests asking for payment or personal information, we strongly advise you to report them immediately to our HR department at px@innovaccer.com. Additionally, please exercise caution and verify the authenticity of any requests before disclosing personal and confidential information, including bank account details.