4529- Coding Specialist
RemoteUnited States
Job Summary
Independently review, analyze, and resolve all assigned front-end claims to ensure accurate and timely submission while maintaining a minimum of 90% coding accuracy. Assign ICD-10-CM and CPT codes with appropriate modifiers, review medical documentation to determine appropriate codes for documented services, and ensure all diagnosis codes meet local and national medical necessity guidelines. Utilize internal resources and payer guidelines to maintain compliance with HIPAA regulations and industry standards. Actively participate in department meetings, mentorship sessions, and team discussions while escalating client trends and coding questions to the Coding Team Lead. Maintain current knowledge of laws, regulations, and payer policies, complete all CEU requirements, and perform other duties as assigned.
Required Qualifications
- Must hold a current AAPC or AHIMA Certification for a minimum of 3 years
- Strong working knowledge of CPT, ICD-10-CM, medical terminology, anatomy and physiology, and state and federal Medicare reimbursement guidelines
- Familiarity with proper English grammar, usage, and professional documentation standards
- Ability to research and analyze data, draw logical conclusions, and resolve coding or documentation issues
- Ability to read, interpret, and apply policies, procedures, laws, and regulations
- Ability to accurately read and interpret medical documentation, clinical terminology, and documented procedures
- Demonstrated ability to exercise independent judgment in coding and claim resolution
- Excellent written and verbal communication skills, including the ability to prepare reports, clarify documentation needs, and maintain collaborative working relationships with physicians and staff
- Strong commitment to maintaining confidentiality and safeguarding protected health information
- Prior experience working in a medical billing environment with strict adherence to HIPAA compliance requirements
- Demonstrated proficiency in Microsoft Office Suite (Word, Excel, Outlook, Teams)
- Minimum of 3+ years of professional coding experience
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