Hospital Coding Specialist

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

📋 Description

• Review and evaluate clinical documentation to accurately assign diagnosis, procedure, and service codes for facility and professional billing.

• Code encounters for inpatient, outpatient, emergency department, observation, clinic, and ambulatory surgery.

• Assign ICD-10-CM, ICD-10-PCS, CPT, HCPCS Level II, and relevant modifiers in line with official coding guidelines.

• Ensure the accuracy, completeness, and compliance of coding with CMS, Medicare, Medicaid, commercial payers, and regulatory standards.

• Query providers when documentation lacks the specificity required for precise code assignment.

• Engage in coding quality reviews, audits, and educational initiatives.

• Meet the productivity and quality standards set by the organization.

• Conduct research on coding regulations, payer policies, and reimbursement guidelines.

• Assist with denial management, appeals, charge capture reviews, and efforts to optimize the revenue cycle.

• Support the onboarding and mentoring of junior coding staff when assigned.

• Perform additional duties as needed.

⛳️ Requirements

• High School Diploma or GED.

• Associate's degree in Health Information Management, Health Information Technology, Nursing, or a related healthcare field is preferred.

• Active credentials such as CPC, CCS, CIC, COC, or CRC (coding certification must align with the role).

• RHIT or RHIA credentials are preferred.

• Over 5 years of experience in hospital coding for professional fees and facilities.

• Proven experience in coding both inpatient and outpatient hospital encounters.

• Experience coding across multiple clinical specialties, including at least one surgical specialty.

• Familiarity with at least two major hospital EMR platforms (Epic, Cerner, Oracle Health, Meditech, TruBridge, CPSI Encoder).

• Proficient with at least two major coding encoders (3M Codefinder, 360 Encompass, Optum EncoderPro, TruCode Encoder, Dolbey Fusion CAC).

• Specialty coding experience (ER, IP, OBS, Swing) is strongly preferred.

• Experience with coding audits, second-level reviews, and coder coaching is preferred.

• Knowledge of denial management, payer policy research, and appeals support is preferred.

• Strong understanding of ICD-10-CM, PCS, CPT, HCPCS, modifiers, and E/M guidelines.

• Experience with encoder/grouper tools, EHR workflows, and claim edit concepts (e.g., NCCI).

• Ability to code without encoder/grouper tools.

• Solid knowledge of HIPAA, documentation standards, and audit expectations.

• Capability to work independently in a remote, metric-driven environment.

🏝️ Benefits

• Access to a 401(k) Retirement Savings Plan.

• Comprehensive Medical, Dental, and Vision Coverage.

• Paid Time Off.

• Paid Holidays.

• Additional benefits, including Pet Care Coverage, Employee Assistance Program (EAP), and discounted services.