Certified Medical Coding Specialist – Professional Based

Job Description:

• Review and analyze professional medical records, including office visits, hospital-based professional services, and outpatient encounters
• Assign accurate ICD-10-CM, CPT, and HCPCS codes
• Apply appropriate CPT modifiers, units, place of service indicators, and payer-specific billing rules
• Abstract and enter coded data into Epic and other professional billing and coding systems
• Ensure compliance with official coding guidelines, regulatory requirements, payer policies, and organizational standards
• Maintain a minimum coding accuracy rate of 95% and meet established productivity benchmarks
• Review, investigate, and resolve claim edits and coding-related errors
• Validate provider documentation and query providers for clarification or additional detail when needed
• Serve as a subject matter expert for professional coding, including E/M services, procedure coding, and modifier usage
• Collaborate with providers, clinical staff, educators, and revenue cycle teams to resolve coding and documentation issues
• Monitor and communicate coding and documentation trends impacting professional billing and compliance
• Stay current on coding updates, regulatory changes, and professional billing requirements
• Participate in audits, education, training, and continuous improvement initiatives
• Perform other duties as assigned

Requirements:

• High School diploma or equivalent required
• Associate degree in Health Information Management or a closely related field preferred
• Certification (Required at Time of Hire) Certified Coding Specialist (CCS), or Certified Professional Coder (CPC), or Certified Coding Specialist – Physician-Based (CCS-P)
• Additional HIM certifications (RHIT, RHIA) preferred
• Minimum of two (2) years of professional coding experience in a multispecialty physician setting
• Experience with ICD-10-CM, CPT, and HCPCS coding systems
• Knowledge of professional coding guidelines and compliant coding practices
• Knowledge of medical terminology, anatomy, physiology, and regulatory compliance (CMS, HIPAA)
• Proficiency with Epic and coding/encoder software preferred
• Strong analytical, problem-solving, written, and verbal communication skills.

Benefits:

• Health, dental, prescription, and vision coverage for full-time & part-time employees
• Life insurance
• Short- and long-term disability
• Flexible Spending Accounts (FSA)
• Competitive pay
• Tuition Reimbursement
• Nursing Student Loan Paydown Program
• 403(b) Retirement Savings Plan
• Education & Paid training courses for continued career progression
• So much more!

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