Certified Coding Specialist

Essential Duties

• Review medical records for documentation accuracy, completeness, and coding requirements.
• Assign ICD-10-CM, ICD-10-PCS, CPT, and HCPCS codes in accordance with established coding guidelines.
• Code inpatient, swing bed, Emergency Department, observation, same day surgery, endoscopy, Rural Health Clinic, and other outpatient encounters.
• Review and reconcile charges to support accurate billing and reimbursement.
• Identify documentation deficiencies and coordinate provider queries in accordance with policies and compliance standards.
• Support internal and external coding audits, record reviews, and corrective action activities.
• Monitor compliance with applicable coding guidelines, regulatory requirements, and reimbursement standards.
• Collaborate with clinical, billing, and Health Information Management staff to resolve coding and documentation discrepancies.
• Participate in quality improvement initiatives and coding education as needed.
• Maintain confidentiality and security of patient health information in accordance with HIPAA and hospital policies.
• Maintain required professional credentials and continuing education.

Minimum Qualifications

• High school diploma or equivalent.
• Current, active coding or health information management credential from AHIMA or AAPC.
• Ability to interpret medical documentation and apply appropriate coding guidelines across multiple healthcare settings.

Required Certifications

• AHIMA: CCS, CCS-P, RHIT, or RHIA
• AAPC: CPC, COC, or CIC

Certification must remain active throughout employment.

Preferred Qualifications

• CCS, RHIT, RHIA, or CIC certification.
• Three or more years of medical coding experience.
• Experience coding in a Critical Access Hospital or rural healthcare setting.
• Experience with inpatient, swing bed, Emergency Department, observation, same day surgery, endoscopy, Rural Health Clinic, and outpatient services.
• Familiarity with healthcare billing, charge reconciliation, coding audits, documentation improvement, and regulatory compliance.

Knowledge and Skills

• Knowledge of ICD-10-CM, ICD-10-PCS, CPT, HCPCS, and official coding guidelines.
• Knowledge of anatomy, physiology, pharmacology, medical terminology, and healthcare documentation requirements.
• Ability to analyze medical records and apply coding guidelines accurately and consistently.
• Strong attention to detail, organization, and time management.
• Ability to meet productivity and quality standards while maintaining coding accuracy and compliance.
• Effective written and verbal communication skills.
• Ability to work collaboratively with providers and interdisciplinary teams.
• Proficiency with electronic health records, coding software, and related computer applications.