As a Coding Specialist, you will play a critical role in ensuring the accuracy, integrity, and compliance of patient health records. You will review clinical documentation, assign appropriate diagnostic and procedural codes, support reimbursement processes, and collaborate with providers to promote accurate clinical documentation and coding practices.
You will:
- Review and analyze medical records for completeness and compliance with organizational, state, and federal requirements
- Abstract clinical information from medical records, charts, and supporting documentation
- Assign accurate ICD-10-CM, ICD-10-PCS, CPT, HCPCS, and modifier codes based on provider documentation and coding guidelines
- Ensure coded records support reimbursement, quality reporting, research, and regulatory compliance
- Verify patient information and confirm documents are matched to the correct medical record
- Maintain knowledge of coding regulations, reimbursement methodologies, and compliance requirements through continuous education
- Review and resolve coding-related claim denials and assist with resubmissions as needed
- Monitor delinquent and deficient records to support compliance with Medicare, Medicaid, and organizational standards
- Collaborate with physicians and clinical staff to improve documentation quality and support clinical documentation improvement initiatives
- Participate in quality improvement activities and coding audits as assigned
- Use electronic health records and coding software to ensure accurate and timely coding and record completion
- Maintain confidentiality and security of patient information in accordance with HIPAA requirements
Requirements & Qualifications
Required education:
- High School Diploma or GED
Required licenses and certifications:
- Current coding certification through AAPC or AHIMA, such as CPC, CCS, CCA, RHIT, RHIA, or equivalent
Preferred experience:
- Two or more years of medical coding experience
- Equivalent combination of education and related experience may be considered
Required skills and qualifications:
- Knowledge of ICD-10-CM, ICD-10-PCS, CPT, HCPCS, and modifier assignment
- Strong understanding of medical terminology, anatomy, physiology, and disease processes
- Knowledge of healthcare reimbursement methodologies and regulatory requirements
- Strong attention to detail and commitment to accuracy
- Excellent organizational, communication, and problem-solving skills
- Ability to independently prioritize workload and meet productivity standards
- Proficiency with electronic health records and coding software
- Ability to maintain confidentiality and handle sensitive information appropriately
Preferred qualifications:
- Experience with hospital and physician coding
- Experience with denial management and claim resolution
- Clinical documentation improvement (CDI) experience
- Familiarity with Medicare, Medicaid, and commercial payer guidelines
Location
Iowa, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
Yes
Posted
4 weeks ago