Coding Specialist – I

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

📋 Description

• Conduct independent reviews, analyses, and resolutions of assigned front-end claims to ensure accurate and timely submissions.

• Handle an average of 10 front-end holds per hour.

• Maintain a minimum coding accuracy rate of 90%.

• Assign ICD-10-CM and CPT codes with the appropriate modifiers within the professional fee environment.

• Review medical records and documentation to identify the appropriate service and diagnosis codes.

• Ensure that diagnosis codes comply with local and national medical necessity guidelines.

• Utilize internal coding resources, payer guidelines, and reference materials to achieve accurate and compliant coding.

• Adhere to HIPAA regulations while safeguarding privacy and confidentiality.

• Stay updated on laws, regulations, payer policies, and industry guidance.

• Engage in departmental, one-on-one, and mentorship meetings with the designated Coding Team Lead.

• Raise client trends and coding-related inquiries to the designated Coding Team Lead.

• Fulfill and complete CEU requirements.

• Perform additional assigned tasks.

⛳️ Requirements

• Must possess a current AAPC or AHIMA Certification for at least 3 years.

• Strong working knowledge of CPT, ICD-10-CM, medical terminology, anatomy and physiology, as well as state and federal Medicare reimbursement guidelines.

• Familiarity with proper English grammar, usage, and professional documentation standards.

• Capability 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 effectively.

• Proficient in accurately reading and interpreting medical documentation, clinical terminology, and documented procedures.

• Proven 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 upholding confidentiality and protecting health information.

• Prior experience in a medical billing environment, adhering strictly to HIPAA compliance requirements.

• Demonstrated proficiency in Microsoft Office Suite (Word, Excel, Outlook, Teams).

• Minimum of 3+ years of professional coding experience.

🏝️ Benefits

• 20 days of fixed time off each year, in addition to company holidays.

• Generous parental leave.

• Monetary incentives and company-wide recognition for impact and dedication.

• Medical, dental, and vision insurance.

• 100% company-paid short- and long-term disability insurance.

• 100% company-paid basic life insurance.

• Discounted legal aid.

• Pet insurance.