Sr Clinical Coding Specialist -Evaluation and Management Coder

About the role

The Senior Clinical Coding Specialist plays a critical role in ensuring accurate and compliant coding of patient encounters, supporting timely billing and reimbursement processes, and maintaining the integrity of clinical data across systems. This position works remotely and collaborates closely with coding professionals, leadership, and clinical partners.

Responsibilities

• Communicate effectively with coding team members, management, business office staff, and external stakeholders
• Provide detailed questions and feedback to management and coordinators on coding issues, reviews, and training needs
• Offer supportive input on internal and external coding correction requests and re-reviews
• Report workflow issues and system concerns promptly to management
• Pursue professional development through continuing education, literature, coding rounds, seminars, and training forums
• Provide feedback on documentation challenges and potential compliance concerns
• Identify opportunities for coding clinic updates and process improvements
• Participate actively in team and departmental meetings
• Maintain pre-AR accounts and baseline thresholds as directed by coding leadership
• Apply official coding guidelines, coding clinics, departmental policies, and Craneware usage appropriately
• Initiate physician queries when documentation is unclear, ambiguous, or incomplete
• Review medical records and assign accurate Evaluation and Management CPT, ICD-10 CM, LCD/NCD, and NCCI codes
• Utilize EPIC and coding resources to ensure correct professional claim coding
• Adhere to AHIMA and AAPC ethical coding standards and HIPAA compliance regulations

Qualifications

• Required: Associate's Degree in Health Information Management, Healthcare Administration, or related healthcare field
• Preferred: Bachelor's Degree in Health Information Management, Healthcare Administration, or related healthcare field
• Required: 5 years Clinical coding experience for complex or multi-specialties
• May substitute required education degree with additional years of equivalent experience on a one to one basis
• Required: Required: Evaluation & Management, in office procedures, oncology coding, EPIC experience, and auditing experience
• Required: Required: RHIA - Registered Health Information Administrator by the American Health Information Management Association (AHIMA)
• Required: Required: RHIT - Registered Health Information Technician by the American Health Information Management Association (AHIMA)
• Required: Required: CCS-Certified Coding Specialist by the American Health Information Management Association (AHIMA)
• Required: Required: CCA - Certified Coding Associate by the American Health Information Management Association (AHIMA)
• Required: Required: Certified Coder-AHIMA or AAPC by the American Academy of Professional Coders (AAPC)
• Required: Required: CPC-A - Cert Prof Coder-Apprentice by the American Academy of Professional Coders (AAPC)
• Required: Required: COC - Certified Outpatient Coding by the American Academy of Professional Coders (AAPC)
• Preferred: Preferred: Certified Coding Specialist (CCS-P) by the American Academy of Professional Coders (AAPC)

Benefits

• Employer-paid medical coverage starting day one for employees working 30+ hours/week, plus optional group dental, vision, life, AD&D, and disability insurance
• Accruals for PTO and Extended Illness Bank, plus paid holidays, wellness, childcare, and other leave options
• Tuition Assistance Program after six months of service and access to extensive wellness, fitness, and employee resource groups
• Defined-benefit pension through the Teachers Retirement System, voluntary retirement plans, and employer-paid life and reduced salary protection programs