Regional Coding Specialist

About the Role

The Regional Coding Specialist is responsible for carefully reviewing charge tickets, patient charts, and supporting documentation to ensure codes are accurate, complete, and sequenced correctly in accordance with government regulations, insurance requirements, and applicable coding guidelines.

Responsibilities

• Receive and review charge tickets, patient charts, and supporting documentation for accuracy and completeness
• Review and assign missing CPT, HCPCS, ICD-10-CM, and modifier codes to claims
• Ensure codes are accurate, current, active, and sequenced correctly in accordance with government regulations, insurance requirements, and applicable coding guidelines
• Perform accurate charge entry
• Identify and report missing, incomplete, insufficient, or unclear documentation
• Follow up with physicians regarding documentation that is insufficient or unclear
• Communicate with physicians and other clinical staff regarding documentation and coding requirements
• Research and resolve complex or unusual coding cases
• Serve as a resource for coding questions and insurance-related resolutions
• Meet established daily coding production and quality standards
• Update and maintain document lists and other coding-related records
• Follow coding guidelines and legal requirements to ensure compliance with federal and state regulations, health plan reimbursement requirements, and coverage policies
• Identify recurring system errors, workflow issues, and training gaps and assist with root cause analysis and resolution
• Perform additional duties as assigned by the supervisor

Requirements

• Minimum of two years of medical coding experience
• Strong computer skills, including data entry, coding, and experience with Electronic Medical Record (EMR) software
• Accurate and precise attention to detail
• Goal-oriented, organized team player with the ability to work independently
• Ability to multitask, prioritize, and manage time efficiently
• Understanding of medical terminology, anatomy, and physiology
• Proficient knowledge of computers and software, including:
  • Microsoft Windows OS
  • Google Docs
  • Microsoft Word
  • Microsoft Excel

Qualifications

• Medical Coding Certificate preferred
• Certified Professional Coder (CPC) by the American Academy of Professional Coders (AAPC) (preferred)
• Certified Billing and Coding Specialist (CBCS) by the National Healthcareer Association (NHA) (preferred)
• Qualified Medical Podiatry Coder (QMPC) by QPro (preferred)

Benefits

• Health Insurance (Single & Family plans available)
• Life Insurance
• Disability Insurance
• 401(k) plan with Company Match
• Employee Discount Program
• Paid Time Off
• Paid Holidays