Coding Specialist III

Reviews and analyzes complex clinical documentation to accurately assign diagnosis and procedure codes that support compliant reimbursement and quality reporting. Applies expert‑level knowledge of inpatient coding rules to ensure accurate severity of illness, risk of mortality, and regulatory compliance. Serves as a technical resource through documentation clarification, audit support, education, and mentoring to strengthen coding quality and consistency across the organization.

• *Commits to the mission, vision, beliefs and consistently demonstrates our core values.

• *Reviews complex inpatient medical records to identify and assign accurate codes.

• *Determines principal diagnoses, secondary conditions, complications, procedures, present on admission (POA) indicators, hospital-acquired conditions, and discharge dispositions.

• *Applies MS-DRG and APR-DRG methodologies to support accurate reimbursement, severity of illness, risk of mortality, and quality outcomes.

• *Enters coded data into designated systems to meet established accuracy, productivity, and turnaround standards.

• *Queries providers to clarify documentation and resolves advanced coding edits and discrepancies.

• *Supports coding audits, peer reviews, and quality assurance activities for compliance and accuracy.

• *Educates providers and team members on coding rules, documentation standards, and best practices.

• *Mentors and trains coding team members to build technical knowledge and consistency.

• Maintains confidentiality and adheres to ethical coding and regulatory requirements.

• Maintains professional growth and development through seminars, workshops, and professional affiliations to keep abreast of latest trends in field of expertise.

EDUCATION AND EXPERIENCE:

High school diploma or equivalent required. Completion of formal coursework in ICD‑10‑CM, CPT and medical coding principles from an accredited or approved program required.

Two (2) years of inpatient medical coding experience, including high‑complexity cases; advanced knowledge of ICD‑10‑CM, ICD‑10‑PCS, MS‑DRG/APR‑DRG methodologies, POA indicators, and quality reporting concepts; proficiency with electronic health records and coding systems.

OTHER CREDENTIALS / CERTIFICATIONS:

One (1) of the following required:

• Registered Health Information Administrator (RHIA)

• Registered Health Information Technician (RHIT)

• Certified Coding Specialist (CCS)

• Certified Coding Specialist - Physician‑Based (CCS‑P)

• Certified Professional Coder (CPC)

• Certified Inpatient Coder (CIC)