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About the role
Key responsibilities & impact- Perform advanced institutional and professional healthcare coding
- Apply ICD-CM, ICD-PCS, HCPCS, and CPT coding systems
- Apply reimbursement methodologies including PPS, DRGs, APCs, and RBRVS
- Use knowledge of clinical documentation, healthcare compliance, revenue cycle management, EHR workflows, and coding audit principles
- Ensure accurate reimbursement and regulatory compliance
- Support continuous process improvement
- Work with medical specialties, diagnostic and therapeutic procedures, ancillary services, and coding-related revenue cycle processes
- Apply government and commercial reimbursement guidelines and identify potential fraud and abuse risks
Requirements
What you’ll need- Five (5) years of medical coding and/or auditing experience in two (2) or more medical, surgical, and ancillary specialties within the past 10 years; OR three (3) years of medical coding or auditing experience if that experience was in a Military Treatment Facility
- A minimum of one (1) year of documented performance in the specialty
- Inpatient coding experience
- Completion of an Associate's Degree or higher in Health Information, Healthcare Administration, Biological Science; OR a University Certificate in medical coding; OR at least 30 semester hours of university/college credit including relevant coursework; OR successful completion of an AAPC or AHIMA coding certification preparation course; OR successful completion of qualifying military or U.S. Maritime Service medical training
- One certification from each group for a total of two certifications: professional certification (AAPC CPC or AHIMA CCS-P) and institutional certification professional (AAPC CIC or AHIMA CCS) or institutional certification (AHIMA RHIA or AHIMA RHIT)
- Minimum 80% passing score on the medical coding test
- Advanced knowledge of ICD-CM, ICD-PCS, HCPCS, CPT, PPS, DRGs, APCs, and RBRVS
- Knowledge of medical terminology, anatomy and physiology, pharmacology, disease processes, medical specialties, diagnostic and therapeutic procedures, ancillary services, and revenue cycle management
- Knowledge of government and commercial reimbursement guidelines, healthcare fraud and abuse regulations, coding audit principles, clinical documentation improvement, process improvement, and EHR workflows
- U.S. Citizenship is required
- Ability to lift 20–25 pounds independently may be required
- Ability to sit for long periods and use a computer
Benefits
Comp & perks- H&W
- Flexible scheduling
- Remote work
- Up to 40 hours per week
- Equal opportunity and affirmative action employer committed to a diverse and inclusive workforce