The Coding Specialist is responsible for coordinating and participating in the coding of medical services from a variety of complex records and coding edits, including diagnosis, treatment of illness, and procedures performed, while ensuring accuracy and adherence to established coding procedures for ICD-10 and CPT-4 in the ambulatory practice setting. This role ensures compliance with all applicable regulations, supports correct reimbursement, and helps clinical and administrative staff understand documentation and coding requirements.
Responsibilities include reviewing and analyzing medical records for accurate coding of diagnoses and procedures, verifying provider documentation, ensuring compliance with regulations and payer policies, collaborating with providers and billing teams, resolving claim edits and denials, tracking assigned claims and accounts, staying current with coding changes, maintaining follow-up documentation, participating in audits and quality initiatives, providing education to staff, supporting SOX control review, running daily and monthly billing reports, and performing related duties such as insurance verification, prior authorization, patient registration, charge posting, and payment reconciliation.
High school diploma or equivalent required; associate degree in Health Information Management or a related field preferred.
One or more of the following certifications required or preferred:
- CPC (Certified Professional Coder) — AAPC
- CCS-P (Certified Coding Specialist — Physician-based) — AHIMA
- CPC-A, COC, or equivalent credential considered with relevant experience
Experience in healthcare required.
Minimum of 2 years of medical coding experience in an ambulatory or outpatient setting such as family medicine, specialty practice, or urgent care.
Preferred experience:
- Multispecialty coding
- Surgery coding
- ICD-10-CM, CPT, and HCPCS Level II
- E/M coding and documentation guidelines
- EHR and practice management systems
Skills and abilities:
- Strong attention to detail and analytical skills
- Excellent written and verbal communication
- Ability to interpret and apply complex regulatory and payer coding requirements
- Strong organizational and time-management skills
- Discretion and respect for patient confidentiality and HIPAA compliance
Medical, dental, and vision coverage
Life and disability insurance
Healthcare FSA, dependent care FSA, and HSA options
401(k) plan
Employee Stock Purchase Program
Some benefits provided at no cost, while others require employee/company cost share
Voluntary plans available through payroll deduction
Location
N/A
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
No
Posted
1 month ago