Coding Suspend Specialist

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

📋 Description

• Examine and evaluate coding-related suspends produced by coding software or systems.

• Detect errors, discrepancies, and any missing information.

• Review medical records, encounter forms, and pertinent documentation to validate code assignments and ensure compliance.

• Investigate and interpret CPT, ICD-10, HCPCS, payer-specific requirements, coding guidelines, policies, and regulations.

• Accurately assign and sequence diagnosis and procedure codes.

• Collaborate with coding and billing staff, clinicians, and other stakeholders to gather information and resolve coding issues.

• Correct code assignments, modifiers, and other coding elements to address suspends and guarantee accurate claim submission.

• Document coding activities, findings, and resolutions within coding systems.

• Communicate coding trends, issues, and best practices; provide education, training, and support.

• Monitor changes in coding guidelines, regulatory requirements, and payer policies, implementing necessary updates.

• Assist with coding audits, reviews, and compliance initiatives.

• Engage in coding-related meetings, committees, and projects.

⛳️ Requirements

• A Bachelor's degree in any Life Science field.

• Certified Coding Specialist (CCS), Certified Professional Coder (CPC), or a related coding certification is required.

• A minimum of 2–3 years of experience in medical coding, particularly in coding suspends and denials.

• Extensive knowledge of CPT, ICD-10, HCPCS, and other coding systems and guidelines.

• Familiarity with coding software and systems, including encoders, grouper software, and Electronic Health Record (EHR) systems.

• Strong analytical and problem-solving abilities.

• Exceptional attention to detail and accuracy.

• Effective communication and interpersonal skills.

• Proficient in medical terminology, anatomy, physiology, and disease processes.

• Capability to work independently and prioritize tasks in a fast-paced healthcare environment.

• Commitment to staying informed on coding-related trends, regulations, and best practices through continuing education and professional development.

🏝️ Benefits

• Performance-based incentive plan.

• Discretionary incentive bonus.

• Referral bonus.

• Opportunities for professional development and continuing education.

• Reasonable accommodations for qualified individuals with disabilities.