Medical Coding Specialist
About the role
Assigns diagnosis and procedure codes to professional billing encounters based on medical record documentation and applicable coding guidelines.
Reviews and codes moderately complex cases, including encounters involving multiple diagnoses, comorbid conditions, or complex documentation scenarios.
Utilizes revenue cycle and coding systems to review assigned work queues, identify coding-related claim issues, and independently resolve routine and moderately complex discrepancies.
Collaborates with providers and clinical staff to clarify documentation and improve the quality and completeness of clinical documentation to support accurate coding and billing.
Participates in coding quality assurance activities and ensures compliance with federal, state, payer, and organizational coding guidelines while maintaining productivity and quality standards.
Responsibilities
- Assigns diagnosis and procedure codes to professional billing encounters based on medical record documentation and applicable coding guidelines.
- Reviews and codes moderately complex cases, including encounters involving multiple diagnoses, comorbid conditions, or complex documentation scenarios.
- Utilizes revenue cycle and coding systems to review assigned work queues, identify coding-related claim issues, and independently resolve routine and moderately complex discrepancies.
- Collaborates with providers and clinical staff to clarify documentation and improve the quality and completeness of clinical documentation to support accurate coding and billing.
- Participates in coding quality assurance activities and ensures compliance with federal, state, payer, and organizational coding guidelines while maintaining productivity and quality standards.
Requirements
- Minimum of an Bachelors Degree in HIM, Medical Coding, or related field; or a minimum of high school diploma or GED and 2 years work experience in medical coding can be substituted for Bachelors Degree.
- CPC (AAPC Certified Professional Coder), CCA (Certified Coding Associate), or CCS-P (Certified Coding Specialist - Physician) certification is required.
- Demonstrated knowledge of Medicare, Medicaid, and commercial payer policies, including coding compliance standards and regulatory requirements.
- Demonstrated knowledge of CPT and HCPCS coding systems, medical terminology, anatomy and physiology, and professional billing coding guidelines.
- Demonstrated knowledge of ICD10 is required.
- Experience utilizing coding and revenue cycle systems to review work queues, resolve coding edits, and support accurate claim submission.
Qualifications
- Bachelor’s degree in Healthcare Informatics, Medical Coding, or related field, or equivalent combination of education and experience.
- At least 2 years of relevant work experience in medical coding.
- Certification as a CPC (AAPC Certified Professional Coder), CCA (Certified Coding Associate), or CCS-P (Certified Coding Specialist - Physician).
- Knowledge of Medicare, Medicaid, and commercial payer policies, including coding compliance standards and regulatory requirements.
- Knowledge of CPT and HCPCS coding systems, medical terminology, anatomy and physiology, and professional billing coding guidelines.
- Knowledge of ICD10.
- Experience utilizing coding and revenue cycle systems to review work queues, resolve coding edits, and support accurate claim submission.
Skills
- Proficiency in CPT and HCPCS coding systems.
- Strong understanding of medical terminology, anatomy, and physiology.
- Ability to interpret and apply coding guidelines and regulations.
- Effective communication skills to collaborate with providers and clinical staff.
- Attention to detail and ability to manage multiple tasks simultaneously.
Benefits
Note: This is a single position that may be listed under different titles to reflect common industry search terms, including Medical Coding Specialist, Physician Coding Specialist, Clinical Coding Specialist, Medical Coder, or Coding Specialist.
Pay
Pay Range $26-30 per hour
Schedule
Schedule Monday- Friday 8:00am-4:30pm or 8:30am-5:00pm