Coding Specialist

This is a fully remote position, open to applicants in Kansas, +3 more states.

📋 Description

• Execute complex professional coding independently across various specialties and settings, including office/clinic, hospital outpatient, ED/urgent care, ASC, SNF/nursing home, and telehealth.

• Accurately code intricate professional encounters and procedures, ensuring correct sequencing, the use of modifiers, E/M level selection, and alignment with documentation.

• Address coding-related edits and denials by pinpointing root causes, coordinating documentation clarifications, and assisting with rebilling actions as necessary.

• Implement payer medical policies, NCCI guidelines, global service considerations, and telehealth coding regulations for professional-fee claims.

• Offer immediate guidance to colleagues on standard coding scenarios and foster consistency through the sharing of best practices.

• Engage in internal quality review initiatives and execute educational or corrective measures based on findings.

• Assess documentation within EHR systems across various settings utilizing Epic professional coding work queues and encoder tools.

• Recognize opportunities for documentation improvements and facilitate compliant query workflows.

• Apply risk adjustment principles and HCC validation where applicable.

• Carry out additional responsibilities as assigned.

⛳️ Requirements

• Applicants must reside and work full-time in Arkansas, Kansas, Missouri, Oklahoma, or Texas prior to their first day of employment, or move to one of these designated states.

• A High School diploma or GED is mandatory.

• Minimum of 3 years of experience in physician/provider coding is required.

• CPC or CCS-P certification is required.

• Advanced knowledge of ICD-10-CM, CPT®, HCPCS, and modifiers is essential.

• Strong proficiency in E/M coding and the interpretation of payer policies.

• Competence in Epic professional coding work queues and encoder tools is necessary.

• Capability to efficiently review documentation within the EHR across different settings.

• Strong analytical skills for denial/edits prevention.

• Ability to identify opportunities for documentation enhancement and support compliant query workflows.

• Familiarity with risk adjustment concepts and HCC validation as applicable.

• Capacity to perform essential job responsibilities, with or without accommodation.

🏝️ Benefits

• Flexible remote/hybrid work options.

• Ongoing career development opportunities.

• Competitive salary package.

• Paid time off (PTO).

• 401(k) retirement plan.

• Medical and dental insurance plans.

• Comprehensive benefits package.