Coding Specialist

The Medical Coder assigns accurate diagnosis and procedure codes for inpatient, outpatient, and ambulatory encounters across multiple settings, applying ICD-10-CM, CPT, HCPCS, and modifiers per official guidelines and payer policy. Works in a high-volume outsourced environment with client-specific accuracy and productivity targets, resolves coding-related claim rejections/denials, supports documentation improvement, and stays current with payer policy and regulatory changes. Responsibilities include applying correct modifiers and sequencing, reviewing documentation for medical necessity, drafting compliant physician queries when needed, identifying charge capture errors, and maintaining coding accuracy above client thresholds while meeting daily productivity targets. Requires strong knowledge of coding guidelines, payer policies, HIPAA/CMS regulations, and ongoing continuing education; familiarity with encoder tools and EHR/PMS systems; and ability to collaborate with teams and clients to ensure accurate coding and compliant reimbursement.