Specialty Medical Coder

Selected by Coding Leadership to focus coding expertise on designated inpatient or outpatient high-dollar or specialty account types.

Responsible for maintaining current and high-quality ICD-10-CM, ICD-10-PCS, and/or CPT coding for inpatient and/or outpatient diagnoses and procedural occurrences through review of clinical documentation and diagnostic results, with a consistent coding accuracy rate of 95% or better.

Accurately abstracts data into electronic medical record systems, verifies patient dispositions and physician data, and follows official ICD-10-CM, ICD-10-PCS, and AMA CPT coding guidelines.

Works collaboratively with Health Information Management and Clinical Documentation Specialists to ensure accurate and complete documentation that supports billing and reduces denials. Reports directly to the Regional Coding Manager and supports other leadership as needed.

Primary responsibilities include coding diagnoses, treatments, and procedures, abstracting source documentation, validating admit orders and discharge dispositions, managing assigned coding queues, finalizing accounts on hold, identifying hospital-acquired conditions, querying providers for missing documentation, participating in audits, and working independently in a remote setting.