Accurately audits inpatient, ambulatory surgery, observation, and other outpatient encounters to ensure appropriate reimbursement, research integrity, and compliance with federal and state regulations using ICD-10-CM/PCS and CPT-4 coding systems.
This role serves as a clinical coding subject matter expert, supports coding quality and compliance efforts, and works collaboratively with clinical documentation and coding teams.
Requirements & Qualifications
Education and experience
- High school diploma or equivalent required
- Formal ICD-10-CM, ICD-10-PCS, and CPT-4 training required
- Associate's or bachelor's degree preferred; education may be considered in lieu of experience
- Minimum 2 years of ICD-10-CM/ICD-10-PCS coding and abstracting experience in a Level 1 Trauma hospital, or 4 years of inpatient hospital medical records coding experience
- 2–3 years of ambulatory coding experience
Certifications
- One of the following required:
- Certified Coding Specialist (CCS)
- Registered Health Information Technician (RHIT)
- Registered Health Information Administrator (RHIA)
- Certified Inpatient Coder (CIC)
Key responsibilities and qualifications
- Strong knowledge of ICD-10-CM, ICD-10-PCS, and CPT-4 coding
- Ability to audit complex inpatient and outpatient cases
- Understanding of APR-DRG, SOI, ROM, POA, CDI, PPCs, MHACs, and PQIs
- Ability to analyze documentation issues and provide coding guidance
- Experience training or mentoring coding staff is preferred
Location
Baltimore, Maryland, US
Employment Type
Full-time
Experience Level
Senior
Remote work allowed
Yes
Posted
4 weeks ago