Coding Specialist II

At TriHealth, our Medical Coding Specialists play a key role in supporting accurate, compliant, and high-quality patient care. In this position, you’ll review provider documentation, assign correct ICD and CPT codes, research denials, and collaborate with clinical teams to ensure clarity and consistency in documentation and coding practices.

About the role

This position abstract codes provider documentation and assigns specific and appropriate ICD (International Classification of Diseases) and CPT (Current Procedural Terminology) codes based on clinical documentation and official guidelines/regulations provided by government and insurance carriers. Provides coding expertise to department management, coding staff, clinical staff, and billing staff. Meets or exceeds departmental standards related to quality and productivity.

Responsibilities

• Assists with coding/billing questions from both internal and external customers, including follow-up on denials, research, and review of charts for potential coding issues.
• Follow up with provider on any documentation that is insufficient or unclear and escalate where necessary.
• Communicate with other clinical staff regarding documentation trends.
• Maintains a close working relationship with all departments and internal customers including leadership and consolidates efforts to ensure appropriate and standardized coding procedures are followed.
• Ensures understanding and compliance with coding protocols, rules and regulations from government agencies, insurance companies, and other resources.
• Maintains knowledge of current coding revisions and effectively communicates changes with provider.
• Maintains accurate and current CPT and ICD-10-CM resources within the billing and clinical systems.
• Validate and/or abstract codes specific to diagnoses and procedures, using ICD and CPT codes. Receive and review patient charts and documents to ensure codes are accurate and sequenced correctly and in accordance with government and insurance where applicable.
• Ensure that all codes are current, active, and billable according to CCI.

Requirements

• Associate’s degree (equivalent experience accepted in lieu of degree).
• Coding certification: CPC, CPC-A, CCS-P, CCM, RHIA, RHIT, or CCA.
• Extensive knowledge of ICD-10-CM and CPT coding methodologies.
• Extensive knowledge of medical terminology and anatomy.
• 3-4 years’ experience in a related field.
• Current professional coding credential from AAPC (CPC, COC), PMI (CMC), or AHIMA (CCS-P, CCS, RHIA, RHIT).

Skills

• Abstract coding of inpatient and outpatient medical records.

Benefits

TriHealth offers a comprehensive benefits package including medical, dental, vision, paid time off, retirement plans, and tuition reimbursement. View our benefits page.

Pay

Full-Time (80 hours biweekly).

Schedule

• Day Shift
• No weekend, holiday, or on-call commitment
• Works at Home

Working Conditions

• Climbing: Rarely
• Concentrating: Consistently
• Continuous Learning: Consistently
• Hearing (Conversation): Consistently
• Hearing (Other Sounds): Frequently
• Interpersonal Communication: Consistently
• Kneeling: Rarely
• Lifting <10 Lbs: Rarely
• Lifting 50+ Lbs: Rarely
• Lifting 11-50 Lbs: Rarely
• Pulling: Rarely
• Pushing: Rarely
• Reaching: Rarely
• Reading: Consistently
• Sitting: Consistently
• Standing: Frequently
• Stooping: Rarely
• Talking: Frequently
• Thinking/Reasoning: Consistently
• Use of Hands: Occasionally
• Color Vision: Rarely
• Visual Acuity (Far): Frequently
• Visual Acuity (Near): Frequently
• Walking: Occasionally

TriHealth SERVE Standards and ALWAYS Behaviors

At TriHealth, we believe there is no responsibility more important than to SERVE our patients, our communities, and our fellow team members. To achieve our vision and mission, all TriHealth team members are expected to demonstrate and live the following:

• Serve: ALWAYS…
  • Welcome everyone by making eye contact, greeting with a smile, and saying "hello".
  • Acknowledge when patients/guests are lost and escort them to their destination or find someone who can assist.
  • Refrain from using cell phones for personal reasons in public spaces or patient care areas.
• Excel: ALWAYS…
  • Recognize and take personal responsibility to address and recover from service breakdowns when a customer's expectations have not been met.
  • Offer patients and guests priority when waiting (lines, elevators).
  • Work on improving quality, safety, and service.
• Respect: ALWAYS…
  • Respect cultural and spiritual differences and honor individual preferences.
  • Respect everyone’s opinion and contribution, regardless of title/role.
  • Speak positively about my team members and other departments in front of patients and guests.
• Value: ALWAYS…
  • Value the time of others by striving to be on time, prepared, and actively participating.
  • Pick up trash, ensuring the physical environment is clean and safe.
  • Be a good steward of our resources, using supplies and equipment efficiently and effectively, and will look for ways to avoid waste.
• Engage: ALWAYS…
  • Acknowledge wins and frequently thank team members and others for contributions.
  • Show courtesy and compassion with customers, team members, and the community.