Coding Edits Specialist

This is a fully remote position, open to applicants in Tennessee.

📋 Description

• Assign diagnosis and procedure codes for encounters in the emergency department, same-day surgery, outpatient clinic, observation, inpatient OB newborn, and specialty clinics.

• Analyze documentation that raises questions and resolve identified issues to ensure accuracy in coding.

• Assign ICD-10-CM, CPT, and HCPCS codes in accordance with CMS hospital billing regulations.

• Achieve and maintain a 95% accuracy rate on quality reviews and meet assigned productivity standards.

• Verify, edit, and/or enter charges based on documentation or payer/billing information.

• Adhere to coding workflows and address compliance reviews as needed.

• Submit queries to physicians when clarification of documentation is required.

• Collaborate effectively with physicians, nurses, medical staff, and other hospital personnel.

• Assist in training and reviewing the work of other coders.

• Provide recommendations to the supervisor and implement changes while monitoring results.

• Adjust work schedules to accommodate department needs.

• Participate in coding education webinars, conference calls, seminars, and discussions.

• Complete compliance courses and uphold relevant coding credentials.

• Perform additional related duties as assigned.

⛳️ Requirements

• An associate degree in a health-related field is preferred.

• A minimum of one year of outpatient coding experience in an acute care hospital is preferred.

• Certification as a Certified Coding Associate (CCA), Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or Registered Health Information Technician (RHIT) is preferred.

• Proficiency in ICD-10-CM, CPT, and HCPCS coding systems.

• Familiarity with Ambulatory Payment Categories (APCs), Outpatient Prospective Payment System (OPPS), National Correct Coding Initiative (NCCI) guidelines, Local and National Coverage Decisions, and medical necessity/compliance guidelines.

• Knowledge of relevant rules, regulations, policies, laws, and guidelines impacting coding practices.

• Ability to work effectively in a remote setting using independent judgment and decision-making skills.

• Must be authorized to work in the United States without the need for employer sponsorship.

• Willingness to attend mandatory educational webinars, conference calls, and coding seminars.

• Ability to maintain coding education hours and renew annual coding credentials as required.

• Capability to complete assigned compliance courses within the specified timeframe.

• Adherence to AHIMA’s Code of Ethics and Standards of Ethical Coding.

• Commitment to maintaining confidentiality and safeguarding patient/employee privacy.

🏝️ Benefits

• Multiple tiers of medical, dental, and vision coverage available for both full-time and part-time employees.

• Life, accident, critical illness, and hospital indemnity insurance options.

• Short- and long-term disability insurance coverage.

• Paid family leave benefits.

• Paid time off for employees.

• Tuition assistance for higher education and certification programs.

• Loan assistance programs.

• 401(k) retirement plan with company matching contributions.

• Programs focused on mental, physical, and financial wellness.

• Complimentary gym memberships.

• Access to virtual care appointments.

• Mental health services available.

• Discount programs for various services.

• Continuous learning and career advancement opportunities.

• Flexible scheduling to allow for personalized work hours.

• Option for remote work arrangements.