Medical Coding Specialist
11 hours ago
We are seeking a detail-oriented and experienced Medical Coding Specialist to review clinical documentation, accurately assign codes, and ensure clean claim submission and compliance with payer and regulatory guidelines.
The ideal candidate will have strong knowledge of ICD-10-CM and CPT coding systems, as well as familiarity with U.S. payer guidelines, NCCI edits, and CMS rules.
Key Responsibilities:- Coding and Compliance
- Review and audit provider documentation for coding accuracy and completeness
- Assign or suggest ICD-10-CM and CPT codes in compliance with CMS and payer guidelines
- Communicate with providers for clarification when documentation is unclear or insufficient
- Quality Assurance
- Identify documentation gaps, coding trends, and opportunities for provider education or process improvements
- Collaboration and Communication
- Collaborate with billing staff to resolve coding-related issues
- Professional Development
- Stay current with coding updates, payer policy changes, and specialty-specific coding rules
- Ensure charts meet compliance standards and support appropriate reimbursement
- Maintain strict HIPAA compliance and confidentiality
- Qualifications
- Certified Professional Coder (CPC) from AAPC
- Minimum 2 years' experience in medical coding for U.S.-based providers
- Coding Expertise
- Strong knowledge of ICD-10-CM and CPT coding systems
- Familiarity with U.S. payer guidelines, NCCI edits, and CMS rules
- Technical Skills
- Experience with EMR/EHR systems such as WRSHealth
- Personal Qualities
- High attention to detail and strong coding accuracy
- Ability to work independently and meet deadlines
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