Professional Coding and Documentation Improvement Specialist

This is a fully remote position, open to applicants in Alabama, +2 more states.

📋 Description

• Facilitate compliant coding and documentation by physicians to ensure accurate assignment of diagnoses, Evaluation and Management (E&M), and Current Procedural Terminology (CPT) codes.

• Oversee the content of medical record documentation to guarantee adherence to industry guidelines, laws, and regulations.

• Provide feedback and educational support to providers regarding proper documentation to back code-level selections.

• Identify and communicate recurring areas for improvement in coding and documentation to leadership.

• Review and address requests for education related to coding and documentation.

• Support proactive initiatives aimed at improving documentation within Capital Health Medical Group.

• Examine medical record documentation for accurate assignment and support of diagnoses, CPT, and E&M codes.

• Monitor the E&M codes selected by providers to ensure documentation aligns with medical necessity, code specificity, and compliance.

• Create and present educational materials that promote clear, accurate, and complete documentation.

• Achieve or surpass departmental standards for accuracy and productivity.

• Clearly and constructively communicate documentation opportunities and monitoring results to providers.

• Encourage teamwork and collaboration among staff.

• Attend meetings with hospital and medical staff regarding documentation-related issues.

• Collaborate with revenue cycle teams to address complex coding-related challenges.

• Support professional coders with pre-bill edits as necessary.

• Facilitate necessary changes to capture required documentation on EMR templates.

• Assist in appeals stemming from third-party reviews.

• Serve as a subject matter expert for inquiries related to professional coding and documentation improvement.

• Perform additional duties as assigned.

⛳️ Requirements

• High School Diploma or equivalent.

• Certified Professional Coder (CPC) or Certified Coding Specialist-Physician-based (CCS-P) certification is required.

• Physician coding and training certification.

• Minimum of two years of experience in a professional coding position.

• Experience with ICD-10-CM, CPT, CM, and HCPCS coding.

• Exceptional verbal and written communication skills.

• Understanding of pathophysiology and disease processes.

• Strong knowledge of industry guidelines and laws pertaining to physician coding and reimbursement.

• Research and analytical skills.

• Proficiency in Microsoft Outlook, Word, Excel, and PowerPoint.

• Knowledge of Medical Terminology, Anatomy and Physiology, or Pathophysiology.

• Ability to develop, implement, deliver, and assess coding education plans using various methods.

• Capability to operate multiple EMR systems.

• Ability to work both collaboratively and independently.

• Candidates must reside in New Jersey, Pennsylvania, or Alabama.

🏝️ Benefits

• Medical Plan.

• Prescription drug coverage & In-House Employee Pharmacy.

• Dental Plan.

• Vision Plan.

• Flexible Spending Account (FSA), including Healthcare FSA and Dependent Care FSA.

• Retirement Savings and Investment Plan.

• Basic Group Term Life and Accidental Death & Dismemberment (AD&D) Insurance.

• Supplemental Group Term Life & Accidental Death & Dismemberment Insurance.

• Disability Benefits – Long Term Disability (LTD).

• Disability Benefits – Short Term Disability (STD).

• Employee Assistance Program.

• Commuter Transit.

• Commuter Parking.

• Supplemental Life Insurance, including Voluntary Life Spouse, Voluntary Life Employee, and Voluntary Life Child.

• Voluntary Legal Services.

• Voluntary Accident, Critical Illness, and Hospital Indemnity Insurance.

• Voluntary Identity Theft Insurance.

• Voluntary Pet Insurance.

• Paid Time-Off Program.

• Bonus and/or incentive eligibility determined by role and level.