Medical Coding Specialist – I
Employment Information
Report this job
Job expired or something wrong with this job?
Job Description
Medical Coder responsible for reviewing and resolving front-end claims ensuring accuracy and compliance. Collaborating with revenue partners to reduce rejections and improve reimbursement processes.
Responsibilities:
- The Medical Coder is responsible for independently reviewing, analysing, and resolving all assigned front-end claims to ensure accurate and timely claim submission.
- This position focuses on identifying and correcting coding-related issues prior to claim transmission, applying established coding guidelines, payer requirements, and organizational policies.
- The Medical Coder works closely with revenue cycle partners to prevent claim rejections, support clean claim rates, and promote efficient reimbursement processes.
- This role requires strong attention to detail, foundational coding knowledge, and the ability to work independently in a fast-paced environment.
- Averages 10 front-end holds per hour.
- Maintains a minimum of 90% coding accuracy.
- Assigns ICD-10-CM and CPT codes with appropriate modifiers for services provided in the professional fee environment.
- Reviews medical records and all applicable documentation to determine appropriate codes for documented services and diagnoses.
- Ensures all diagnosis codes meet local and national medical necessity guidelines.
- Utilizes internal coding resources, payer guidelines, and other reference materials to ensure accurate and compliant coding for all assigned services.
- Follows all HIPAA regulations and upholds the highest standards of privacy and confidentiality.
- Maintains current knowledge of laws, regulations, payer policies, and industry guidance impacting compliant coding practices.
- Independently reviews and resolves all assigned front-end claim holds.
- Actively participates in department meetings, one-on-one meetings, and mentorship meetings with the assigned Coding Team Lead.
- Escalates identified client trends to the assigned Coding Team Lead.
- Escalates all coding-related questions to the assigned Coding Team Lead for guidance and clarification.
- Maintains and completes all CEU requirements.
- Performs other duties or tasks as assigned.
Requirements:
- Must hold a current AAPC or AHIMA Certification for a minimum of 3 years.
- Strong working knowledge of CPT, ICD-10-CM, medical terminology, anatomy and physiology, and state and federal Medicare reimbursement guidelines.
- Familiarity with proper English grammar, usage, and professional documentation standards.
- Ability to research and analyze data, draw logical conclusions, and resolve coding or documentation issues.
- Ability to read, interpret, and apply policies, procedures, laws, and regulations.
- Ability to accurately read and interpret medical documentation, clinical terminology, and documented procedures.
- Demonstrated ability to exercise independent judgment in coding and claim resolution.
- Excellent written and verbal communication skills, including the ability to prepare reports, clarify documentation needs, and maintain collaborative working relationships with physicians and staff.
- Strong commitment to maintaining confidentiality and safeguarding protected health information.
- Prior experience working in a medical billing environment with strict adherence to HIPAA compliance requirements.
- Demonstrated proficiency in Microsoft Office Suite (Word, Excel, Outlook, Teams).
- Minimum of 3+ years of professional coding experience.
Benefits:
- Private Health Insurance
- Pension Plan
- Paid Time Off
- Work From Home
- Training & Development
- Performance Bonus
- Health Care Plan (Medical, Dental & Vision)
- Retirement Plan (401k, IRA)
- Life Insurance (Basic, Voluntary & AD&D)
- Paid Time Off (Vacation, Sick & Public Holidays)
- Family Leave (Maternity, Paternity)
- Short Term & Long Term Disability
- Free Food & Snacks
- Wellness Resources
Similar Jobs
Medical Coding Specialist – Wound Care
Office-Based Wound Care Coder at MedHQ responsible for ICD-10 coding for wound care procedures. Collaborating with healthcare providers and billing teams to ensure compliance and maximize reimbursement.
Coding Specialist – Radiology
Remote Coding Specialist responsible for accurate medical coding for Ventra Health. Ensuring compliance with coding guidelines and assisting in training.
Behavioral Health Coder
Behavioral Health Coder assigning ICD and CPT/HCPCS codes for Lifepoint Health. Involves applying coding guidelines and interpreting documentation to ensure compliance.
Risk Adjustment Coder
PACE Risk Adjustment Coder validating medical records' ICD-10-CM codes for healthcare organizations. Responsible for accuracy, quality standards, and HIPAA compliance.
Certified Coder
Certified Coder at Ohio State University Physicians responsible for billing services and compliance. Analyzing medical coding and providing training to healthcare providers and staff.
Medical Coding Specialist
Medical Coder responsible for reviewing assigned front-end claims for healthcare providers. Working closely with revenue cycle partners to ensure accurate and timely claim submissions.
Medical Billing & Accounts Receivable Specialist
Medical Billing & Accounts Receivable Specialist managing claims and accounts for healthcare team. Requires expertise in U.S. healthcare revenue cycle and billing accuracy.
Coding Specialist II – Oncology Profee
Pro Fee Coder reviewing clinical documentation to assign diagnostic codes for billing in the healthcare sector. Ensuring compliance with coding guidelines and maintaining data integrity.
Coder III – Inpatient
Coder III analyzing inpatient health records for Texas Health Family with ICD-10 coding in a remote role. Collaborating with physicians and clinical staff for accurate documentation and coding.
Office Coding Specialist
Coding Specialist providing CPT, HCPCS and ICD-10-CM coding for medical specialties at CorroHealth, ensuring compliance and accuracy in medical coding procedures.
Surgical Coding Specialist
Coding Specialist responsible for CPT, HCPCS, and ICD-10-CM coding for Professional Fee surgeries. Working remotely for CorroHealth, focusing on various surgical specialties.
Profee Multi Specialty Surgery Medical Coder
Medical Coder providing coding and abstracting services for outpatient medical records using established coding principles. Collaborating with healthcare professionals to ensure accuracy and compliance.
Medical Billing Specialist – Payment Posting
Medical Billing Specialist responsible for processing payments and ensuring accuracy in claims for healthcare services. Working from home to provide exceptional customer service and support.
Profee Multi Specialty Surgery Medical Coder
Experienced Medical Coder providing coding and abstracting services for various outpatient medical records. Collaborating with clinical teams and ensuring coding accuracy for healthcare encounters.
Physician Coding Specialist II
Coding Specialist responsible for assigning surgical and office procedural codes for patient health information at Mount Carmel Medical Group. This role involves resolving edits and maintaining coding standards.
DRG Coder
Senior DRG Coder reviewing inpatient medical records and assigning diagnosis codes. Collaborating with various teams to ensure compliance and accuracy in coding and reimbursement processes.
Coder III – Plastics Specialty
Coder III specializing in complex medical coding for Advocate Health across various regions. Providing expert guidance and training while ensuring accurate code assignments and compliance with regulations.
Coder II – Anesthesia
Coder II specializing in anesthesia coding for Advocate Health, performing complex professional fee coding and ensuring compliance with healthcare regulations.
Coder IV – IP DRG
Coder IV reviewing medical records for coding at Denver Health. Ensuring compliance with coding guidelines and maintaining accuracy in diagnoses and procedures.
Outpatient Coding Specialist I
Responsible for accurate coding of outpatient medical records for compliance with CMS regulations and hospital guidelines. Engaging with coding knowledge and maintaining HIPAA compliance while adapting to new coding protocols.