Medical Coding Specialist

Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups, offering end-to-end revenue cycle and point solutions nationwide.

The Medical Coding Specialist reviews medical record documentation to accurately assign ICD-10-CM, ICD-10-PCS, and CPT IV codes based on record type and abstracts specific data elements per federal regulations. Coding applies to outpatient visits including ancillary, urgent care, emergency department, observation, same day surgery, and interventional procedures. The role follows official coding guidelines, AHIMA Coding Ethics, AHA Coding Clinics, CMS directives, and fiscal intermediary communications.

Responsibilities include:

• Reviewing medical records and assigning ICD-9-CM, ICD-10, CPT IV, and HCPCS codes using 3M software tools.
• Abstracting required data per facility specifications.
• Performing medical necessity checks for Medicare and other payers.
• Monitoring and working accounts such as Discharged Not Final Billed, failed claims, and stop bills to ensure compliant outpatient claim processing.
• Maintaining productivity and quality standards.
• Staying current with CMS, NCD, and LCD guidelines and coding software.
• Reporting coding inaccuracies and potential compliance issues.
• Attending required meetings and educational sessions for continued education and growth.

Experience & Qualifications:

• At least 1 year coding experience.
• Proficiency with PC and Microsoft business software.
• Strong organizational, communication, time management, problem solving skills.
• Ability to multi-task and prioritize.
• Experience with EPIC and coding software tools.
• Openness to innovation and AI for process improvement.
• Remote position with travel as needed.

Education & Certification:

• High School Diploma or GED.
• AAPC or AHIMA coding certification: CPC-A, CPC, CCA, or CCS.

Benefits include bonus incentives, paid certifications, tuition reimbursement, comprehensive benefits, and career advancement opportunities.

Ensemble promotes a culture of customer obsession, innovation, and excellence with a commitment to associate growth, recognition, and work-life flexibility.