Coding Specialist
Full-Time (80 hours a pay period) | Revenue Integrity
Schedule: Monday-Friday, set schedule upon hire
Work Arrangement: Hybrid/Remote options available following successful completion of the probationary period
What You'll Do
As a Coding Specialist, you will play a critical role in ensuring accurate, compliant, and timely coding of hospital, clinic, and professional services. Working under the direction of the Director of Revenue Integrity and with day-to-day guidance from the Revenue Integrity Lead, you will review clinical documentation, assign appropriate codes, resolve coding edits, and support clean claim submission while helping optimize reimbursement and regulatory compliance.
In this role, you will:
- Review health records and assign accurate ICD-10-CM, ICD-10-PCS, CPT, HCPCS, modifier, and other required coding elements for assigned service lines.
- Apply official coding guidelines, Coding Clinic guidance, CPT guidance, National Correct Coding Initiative (NCCI) edits, CMS requirements, payer policies, and organizational procedures.
- Sequence diagnoses and procedures appropriately and abstract required clinical, demographic, and billing information into Epic and other approved systems.
- Review coding and claim-edit work queues, resolving assigned edits and escalating complex issues as appropriate.
- Evaluate documentation for coding support and initiate compliant provider clarification or query processes when information is incomplete, conflicting, or ambiguous.
- Identify potential documentation, charge capture, medical necessity, coverage, reimbursement, or workflow concerns and refer issues to the appropriate resources.
- Collaborate with Revenue Integrity Specialists, Health Information Management, Patient Financial Services, clinical departments, and Prior Authorization teams to resolve documentation and billing concerns.
- Provide coding expertise for claim corrections, appeals, denial reviews, and reimbursement-related questions.
- Analyze coding denials, recurring edits, and trends, helping identify opportunities for education and process improvement.
- Participate in internal and external coding audits and complete corrective action plans or education as needed.
- Maintain established productivity, accuracy, quality, and turnaround time expectations.
- Stay current on coding regulations, annual code updates, payer requirements, and specialty-specific coding guidelines.
- Assist with developing coding education materials, job aids, and documentation guidance.
- Clearly document coding decisions, research findings, provider queries, and escalations.
- Protect patient information and maintain compliance with HIPAA, coding ethics, and organizational confidentiality standards.
- Perform all other duties as assigned.
What We're Looking For
We're seeking a detail-oriented coding professional who is committed to coding accuracy, regulatory compliance, and continuous learning. The ideal candidate is analytical, organized, and able to work independently while collaborating effectively with clinical and operational teams.
Required Education
- High School Diploma or equivalent
Preferred Education
- Associate or Bachelor's degree in Health Information Management, Healthcare Administration, or a related healthcare field
Required Licenses & Certifications
- One of the following coding credentials:
- Certified Professional Coder (CPC)
- Certified Coding Specialist (CCS)
- Certified Coding Specialist – Physician-Based (CCS-P)
- Registered Health Information Technician (RHIT)
- Or another comparable coding certification
Required Skills & Qualifications
- Ability to research coding questions and interpret authoritative coding guidance
- Strong understanding of coding regulations, reimbursement methodologies, and compliance requirements
- Ability to identify documentation gaps and initiate compliant provider queries
- Excellent attention to detail and commitment to coding accuracy
- Strong organizational, communication, and problem-solving skills
- Ability to manage competing priorities and meet productivity expectations
- Ability to work independently while maintaining collaboration with cross-functional teams
- Commitment to confidentiality, professionalism, and ethical coding practices
Preferred Experience
- Three or more years of healthcare coding experience
- Experience with hospital, critical access hospital, rural health clinic, physician, or specialty coding
- Experience with Epic or similar electronic health record systems
- Experience using encoder or coding-assistance technology
- Experience supporting denial management, appeals, or revenue cycle operations