Senior Coding Specialist

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

📋 Description

• Implement appropriate coding standards for patient charge encounters within a clinical setting.

• Extract diagnosis and procedural services from physician documentation.

• Assess and rectify coding errors related to charge reviews and claims edits in the electronic health record.

• Review, amend, and appeal coding-related claim denials.

• Provide mentorship and cross-training for Coding Specialists.

• Engage with physicians and staff from the Physician Organization Central Business Office to clarify diagnoses and procedures.

• Work collaboratively with management to minimize claim denials.

• Address internal inquiries regarding medical coding information.

• Participate in coding round tables and in-service training sessions.

• Offer backup support and cross-training for team members.

• Code and abstract medical records for reimbursement purposes, utilizing current coding conventions, guidelines, and tools such as the 3M encoder.

• Verify and confirm diagnoses and procedures for charge reviews, claim edits, and denied claims.

• Submit clinical appeals or corrected claims as necessary.

• Develop and evaluate department-specific coding workflows.

• Ensure accurate coding and billing by matching charge documents, billing sheets, operative reports, and medical records.

• Complete charge review and claim edit processes within two business days.

• Investigate and appeal unpaid, denied, and partially paid third-party claims.

• Provide continuous coding and documentation education to physicians and clinical staff.

⛳️ Requirements

• High School diploma or equivalent qualification.

• Minimum of five years of professional coding experience.

• Possession of one of the following: CCS (Certified Coding Specialist, AHIMA) or CPC (Certified Professional Coder, AAPC).

• Must reside in Texas.

• Proficiency in speaking, reading, and writing in English.

• Familiarity with ICD-9, ICD-10, and CPT coding systems.

• Sound understanding of medical terminology, anatomy, and physiology.

• Proficient in Microsoft Office applications, including Word and Excel.

• Ability to think critically and work independently.

• Capability to multitask in a fast-paced and rapidly evolving healthcare environment.

• Strong skills in training, leadership, and mentoring.

• High degree of professionalism, customer service orientation, interpersonal skills, and confidentiality.

• Willingness to travel within the Houston Metropolitan area.

🏝️ Benefits

• Flexible remote or hybrid work options.

• Full-time employment status.

• Business professional attire is required.

• Opportunities for ongoing professional growth and development.

• Continuing education available through coding round tables and in-service programs.

• Quarterly team meetings focused on coding and revenue integrity.

• Mentorship and cross-training opportunities available.