The Medical Coding Specialist reviews medical records and encounter documentation to ensure accurate, complete, and compliant coding in accordance with ICD-10-CM and CPT guidelines. This role supports compliant billing practices, maximizes reimbursement, and helps ensure adherence to federal, state, and payer regulations, including requirements specific to Federally Qualified Health Centers (FQHCs).
The position works closely with providers, billing staff, and other healthcare team members to clarify documentation, resolve coding issues, and promote best practices in clinical documentation and coding accuracy.
Duties and responsibilities
- Review and analyze patient records and clinical documentation for coding completeness and accuracy.
- Assign and sequence diagnosis and procedure codes using ICD-10-CM and CPT.
- Apply coding guidelines and regulatory requirements to ensure correct code assignment and compliance.
- Stay current on coding rules, regulations, and industry trends through ongoing education and training.
- Communicate with providers to clarify missing, incomplete, or unclear documentation.
- Provide education and feedback to clinical staff on documentation best practices.
- Participate in team meetings related to patient care, billing, and coding updates.
- Translate medical procedures and diagnoses into codes for submission to payers.
- Ensure timely submission of coding information to support claims processing and reimbursement.
- Collaborate with billing staff to resolve coding-related claim issues.
- Maintain confidentiality of patient information in compliance with HIPAA and privacy laws.
- Store coded medical records securely and accurately.
- Keep coding manuals and guidelines current.
- Pursue ongoing professional development and attend workshops, seminars, and training as needed.
- Serve as a resource or mentor to less experienced coding staff when applicable.
- Assist with automation of cash receipt applications and perform other assigned duties.
Physical requirements
- Regular sitting, standing, walking, handling objects, reaching, talking, and hearing.
- Occasional stooping, bending, and lifting or moving up to 25 pounds.
- Requires close, distance, peripheral, and depth vision with ability to adjust focus.
- Proficiency in medical terminology, ICD-10-CM, and CPT coding systems.
- Strong attention to detail and accuracy.
- Knowledge of FQHC billing and reimbursement regulations.
- EPIC experience preferred.
- Effective written and verbal communication skills.
- Ability to work collaboratively with clinical and administrative teams.
- Ability to relate to individuals from diverse backgrounds, cultures, races, sexual orientations, and gender identities.
- Associate’s degree in Health Information Management or a related field required.
- Professional coding certification required (CPC, CCS, or equivalent).
- Minimum of 6 months of professional fee coding experience.
- Commitment to continuous learning and staying current with coding regulations and healthcare requirements.
Location
New York, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
1 week ago