Coding Specialist I – Inpatient Medicine

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

📋 Description

• Reviews medical records to determine the appropriate ICD (diagnosis) and CPT (procedure codes) to assign.

• Leverages coding tools and resources to confirm the accuracy of assigned CPT and ICD codes.

• Extracts data including provider information, injury details, quality measures, and additional relevant information as required.

• Keeps abreast of the latest trends and practices in coding principles and governmental regulations by reviewing literature and/or attending educational meetings or seminars.

• Maintains necessary certification.

• Engages with colleagues and physicians to address and clarify questions and discrepancies in documentation.

• Communicates risk management issues to the relevant parties.

• Completes priority accounts (Holds) on a daily basis.

• Directs complex matters to designated work queues.

• Participates in coder-specific training and education based on audit metrics and trends.

• Reviews and analyzes medical record content to accurately assign ICD diagnosis and procedure codes, as well as CPT procedure codes and modifiers in accordance with national coding guidelines, USACS policies, and SOPs.

• Addresses coding and abstracting inquiries from coding leadership, compliance teams, clinicians, etc.

• Maintains a coding accuracy rate of ≥ 95%.

• Achieves a coding productivity rate (Milestone based standards) of ≥ 95%.

• Accumulates a minimum of 15 CEUs per quarter through Nthrive and/or other company-sponsored webinars and programs.

• Accurately identifies and enters core abstracting elements such as physician and APP attributions.

• Recognizes documentation trends and topics for education/feedback directed at physicians and APPs.

• Remains updated with coding and industry changes by participating in educational opportunities.

• Possesses a thorough understanding of updates from intermediaries, carriers, government agencies, and third-party payers to ensure proper documentation, coding, and compliance.

• Holds extensive knowledge of coding guidelines, medical terminology, anatomy/physiology, reimbursement methodologies, and payor-specific guidelines.

• Assists with special projects as needed and performs related tasks as assigned.

⛳️ Requirements

• High school diploma or equivalent.

• One or more of the following credentials are required prior to the hire date: Certified Coding Specialist (CCS), Certified Professional Coder (CPC-A), Certified Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), or Certified Coding Specialist – Physician-Based (CCS-P).

• Knowledge and experience in ICD and CPT coding.

• Familiarity with payor guidelines.

• Proficiency in using personal computers in a Windows environment, particularly in basic word processing and data entry.

• Ability to operate independently and make decisions.

• Strong attention to detail.

• Capacity to identify, research, and resolve problems and discrepancies.

• Ability to communicate courteously and professionally with employees, management, and physicians.

• Commitment to maintaining confidentiality.

• Capability to organize and process assigned duties efficiently.

🏝️ Benefits

• Options for medical, dental, and vision insurance.

• Health savings accounts (HSA) and flexible spending accounts (FSA).

• 401(k) with both employee and employer contributions.

• Paid time off, including vacation, sick leave, and company holidays.

• Paid parental leave and family support benefits.

• Short-term and long-term disability insurance.

• Life and accidental death & dismemberment (AD&D) insurance.

• Employee assistance programs and wellness resources.

• Additional compensation may include bonus eligibility, equity, or other incentive programs.