Reviews medical record documentation for completeness, consistency, and coding accuracy. Identifies documentation deficiencies, coding discrepancies, and potential compliance concerns, and communicates with providers and appropriate staff to obtain clarification when needed. Uses coding references, encoder software, and other available resources to research and resolve coding questions.
Reviews, analyzes, codes, and abstracts physician services and clinic-based professional fee encounters to ensure accurate assignment of diagnoses, procedures, and services in accordance with current coding guidelines, documentation requirements, and applicable payer policies. Assigns ICD-10-CM diagnosis codes, CPT procedure codes, and HCPCS Level II codes, as applicable, to support accurate billing, reimbursement, regulatory compliance, and quality reporting.
Supports continuous improvement in coding quality and revenue cycle performance while maintaining established coding accuracy and productivity standards.
High school diploma or equivalent required.
Current coding certification through AAPC or AHIMA required. Acceptable credentials may include CPC, CCS, CCS-P, or another approved coding credential appropriate to the position.
Minimum of 2 years of professional medical coding experience preferred, with demonstrated experience coding physician office or ambulatory professional fee services strongly preferred.
Experience with multiple clinic specialties, particularly primary care, OB/GYN, pediatrics, general surgery, gastroenterology, orthopedics, and wound care, is preferred.
Previous medical billing, claims review, or revenue cycle experience is a plus.
Experience with electronic health records, encoder software, and computerized coding resources is preferred.
Knowledge of:
- ICD-10-CM coding conventions, sequencing requirements, official guidelines, and annual code updates
- CPT professional fee coding for evaluation and management services, procedures, and other physician services
- HCPCS Level II coding for applicable supplies, services, and items not fully represented by CPT
- Documentation review and code assignment based on the medical record
- Specialty coding requirements for primary care, OB/GYN, pediatrics, surgery, gastroenterology, orthopedics, wound care, and other assigned specialties
- Coding compliance, payer policies, medical necessity requirements, and regulatory standards
- Evaluation and management coding guidelines, including medical decision-making and time-based coding when appropriate
- Electronic health records, encoder software, coding references, and online research tools
- Revenue cycle fundamentals, including coding impact on claims, reimbursement, denials, and compliance
- Medical terminology, anatomy, physiology, and common disease processes
Strong abilities in accuracy, problem-solving, coding judgment, productivity, organization, communication, research, computer skills, confidentiality, independent work, and continuous learning are required.
Medical, dental, and vision coverage.
457B retirement plan with employer match for full-time employees.
Company-paid short-term disability and long-term disability coverage.
Location
Illinois, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
1 week ago