Coding Specialist II

Key Responsibilities

• Ensure accurate ICD-10-CM and CPT coding with zero errors.
• Validate diagnosis and treatment documentation and query providers for clarification.
• Stay current on coding guideline updates and communicate changes, trends, and payer issues to leadership.
• Use auditing tools to monitor accuracy, identify trends, and drive corrective action.
• Meet productivity benchmarks and maintain active professional coding certification.

Competencies

• Strong analytical, problem-solving, and decision-making skills.
• Clear, adaptable communication and effective listening.
• High integrity, accountability, adaptability, and attention to detail.
• Patient-focused, compassionate, and compliant with ethical standards.
• Proactive, results-driven, quality-oriented, and collaborative.
• Demonstrates continuous learning, initiative, and technical proficiency.

Qualifications

• Associate’s degree or equivalent.
• 1+ year of clinical and/or Medicare Risk Adjustment experience; quality improvement experience preferred.
• Healthcare and insurance industry experience.
• Knowledge of clinical standards, preventive care, and office-based procedures.
• Certified Professional Coder (CPC or equivalent).
• Proficiency in Microsoft Excel, Word, Outlook, and Electronic Medical Record systems.

Physical & Work Requirements

• Primarily sedentary with occasional standing, walking, and lifting up to 25 lbs.
• Requires fine motor skills, visual acuity, and tolerance for a standard office environment.