Single Path Coding Specialist II

The Single Path Coding (SPC) Specialist-Level 2 is an advanced coder role responsible for reviewing clinical documentation to extract data and assign accurate ICD-10-CM diagnostic codes, CPT codes, modifiers, group APCs for billing, and process coding edits related to hospital and professional coding. This position serves as a subject matter expert, collaborating with multiple teams including Patient Financial Services and provider teams, ensuring compliance with policies and regulations, reviewing medical necessity edits, and assisting in workflow design for coding and billing error reduction. The SPC Coding Specialist II must master more than one specialty or possess coding certification in two specialties.

Key duties include assigning diagnosis and procedure codes, validating medical necessity edits, processing payer-specific coding edits, advocating for documentation improvement, monitoring discharged not billed accounts, maintaining quality standards, and staying current with CMS and coding guidelines. The role demands strong independence, critical thinking, communication, and compliance with ethical coding standards and hospital policies.

Candidates must have an Associate Degree or equivalent experience, five years of proficiency in coding surgical specialties, and relevant certifications (RHIA, RHIT, CCS, CPC, COC, or CIRCC). Knowledge of ICD-10, CPT, APC grouping, health information systems (Epic, 3M 360e), and CMS coding compliance is required. The role supports Stanford Health Care's commitment to exceptional patient and family experience through the C-I-CARE framework.