Professional Coding Specialist II - Outreach

To ensure accurate and appropriate gathering of information into coding classification systems to meet departmental, hospital, and outside agency requirements. This role supports reimbursement, compliance, and charging in accordance with coding guidelines and regulatory agencies. It is responsible for obtaining complete and accurate medical record documentation for correct coding assignment, severity of illness, and risk of mortality. The position is part of the overall compliance program related to physician coding and billing functions and works with physician and non-physician providers to support correct coding initiatives. It also analyzes and resolves missing charges and problem accounts by researching reimbursement-related information.

This position works on outreach cases and requires multi-specialty experience.

Core responsibilities

• Review and interpret medical record documentation to identify diagnoses and procedures.
• Assign appropriate ICD-10, CPT, and modifier codes.
• Ensure timely coding, charging, and abstraction of assigned accounts.
• Maintain coding knowledge through review, seminars, meetings, and reference updates.
• Verify accuracy and completeness of data needed for clean billing.
• Contact physicians and other staff to obtain information needed for accurate coding.
• Support revenue cycle operations with claim development and resolution of patient account issues.
• Monitor provider documentation and perform coding audits.
• Provide provider education when coding issues are identified.