Coding Specialist- Patient Accounts
Posted 2025-08-15
Remote, USA
Full Time
Immediate Start
About the position
The Coding Specialist is responsible for the analysis and review of medical record documentation, ensuring accurate coding and compliance with federal regulations. This role involves assigning ICD-10 and/or CPT codes for outpatient medical services, researching newly identified diagnoses and procedures, and performing miscellaneous duties as assigned. The position requires a strong understanding of coding standards and the ability to work collaboratively with various teams to resolve billing and reimbursement issues.
Responsibilities
• Utilizing 3M, CPT, and ICD-10-CM coding books/software to assign CPT and/or ICD-10-CM codes to medical services or charges.
,
• Completing required research to ensure compliance with CCI edits - CPT and ICD-10 coding standards.
,
• Utilizing EPIC workflow to review account CCI edits and resolve as appropriate.
,
• Performing charge reconciliations to ensure all charges are being captured.
,
• Maintaining updated knowledge of coding requirements, including continuing education and certification renewal.
,
• Reviewing and performing necessary coding and billing corrections for all insurance coding and medical necessity denials.
,
• Assisting the billing staff with coding questions.
,
• Consistently meeting the department specific standards for quantity standard.
,
• Consistently coding at a 95% accuracy rate or better (quality standard).
,
• Utilizing Internet and other resources to research newly identified diagnosis and/or other procedures.
,
• Researching CPT and ICD-10 coding discrepancies for compliance and reimbursement accuracy.
,
• Acting as a liaison between the denials team, billers, clinical staff, and leadership in resolving billing and reimbursement issues.
,
• Conducting billing and coding compliance documentation review, which may include review of out-patient medical records to determine appropriateness of procedure and diagnosis coding, as well as evaluation and management coding.
,
• Conducting analysis and applying state and federal healthcare or related regulations to different questions, projects, or inquiries.
Requirements
• Proficient in using 3M, CPT, and ICD-10-CM coding books/software.
,
• Strong understanding of CCI edits and coding standards.
,
• Experience with EPIC workflow for account management.
,
• Knowledge of medical billing and coding compliance documentation.
,
• Ability to conduct research on coding discrepancies and newly identified diagnoses.
Nice-to-haves
• Certification in coding (CPC, CCS, etc.).
,
• Experience in a healthcare setting, particularly in patient accounts or billing.
,
• Familiarity with federal healthcare regulations.
Benefits
• Opportunity for remote work after initial training period based on productivity levels.
,
• Collaborative work environment with a focus on diversity, equity, and inclusion. Apply tot his job
The Coding Specialist is responsible for the analysis and review of medical record documentation, ensuring accurate coding and compliance with federal regulations. This role involves assigning ICD-10 and/or CPT codes for outpatient medical services, researching newly identified diagnoses and procedures, and performing miscellaneous duties as assigned. The position requires a strong understanding of coding standards and the ability to work collaboratively with various teams to resolve billing and reimbursement issues.
Responsibilities
• Utilizing 3M, CPT, and ICD-10-CM coding books/software to assign CPT and/or ICD-10-CM codes to medical services or charges.
,
• Completing required research to ensure compliance with CCI edits - CPT and ICD-10 coding standards.
,
• Utilizing EPIC workflow to review account CCI edits and resolve as appropriate.
,
• Performing charge reconciliations to ensure all charges are being captured.
,
• Maintaining updated knowledge of coding requirements, including continuing education and certification renewal.
,
• Reviewing and performing necessary coding and billing corrections for all insurance coding and medical necessity denials.
,
• Assisting the billing staff with coding questions.
,
• Consistently meeting the department specific standards for quantity standard.
,
• Consistently coding at a 95% accuracy rate or better (quality standard).
,
• Utilizing Internet and other resources to research newly identified diagnosis and/or other procedures.
,
• Researching CPT and ICD-10 coding discrepancies for compliance and reimbursement accuracy.
,
• Acting as a liaison between the denials team, billers, clinical staff, and leadership in resolving billing and reimbursement issues.
,
• Conducting billing and coding compliance documentation review, which may include review of out-patient medical records to determine appropriateness of procedure and diagnosis coding, as well as evaluation and management coding.
,
• Conducting analysis and applying state and federal healthcare or related regulations to different questions, projects, or inquiries.
Requirements
• Proficient in using 3M, CPT, and ICD-10-CM coding books/software.
,
• Strong understanding of CCI edits and coding standards.
,
• Experience with EPIC workflow for account management.
,
• Knowledge of medical billing and coding compliance documentation.
,
• Ability to conduct research on coding discrepancies and newly identified diagnoses.
Nice-to-haves
• Certification in coding (CPC, CCS, etc.).
,
• Experience in a healthcare setting, particularly in patient accounts or billing.
,
• Familiarity with federal healthcare regulations.
Benefits
• Opportunity for remote work after initial training period based on productivity levels.
,
• Collaborative work environment with a focus on diversity, equity, and inclusion. Apply tot his job