Medical Coding Specialist

Position Summary:

The RCM Coding Specialist is responsible for the accurate assignment of ICD-10-CM, CPT, and HCPCS codes based on clinical documentation to ensure compliant billing, timely claim submission, and optimal reimbursement. This role supports pre-claim workflows by identifying and resolving documentation gaps, validating medical necessity, and ensuring clean claim submission to reduce denials. The position collaborates cross-functionally with billing, AR, clinical, and operational teams to resolve coding and data deficiencies while maintaining compliance with payer guidelines and regulatory requirements. In addition to coding responsibilities, the role performs data analysis to identify trends, improve data quality, and drive revenue cycle performance. Success in this role requires strong attention to detail, deep coding expertise, and the ability to manage multiple priorities in a fast-paced environment. Performs other duties as assigned.

Key Responsibilities:

Review clinical documentation and assign accurate ICD-10-CM, CPT, and HCPCS codes in line with official guidelines. Validate medical necessity and ensure coding complies with CMS, payer policies, and regulations. Identify and fix documentation issues that could impact claim submission. Support pre-claim workflows to ensure clean, accurate, and complete claims before billing. Analyze coding-related denials, make corrections, and resubmit claims to support reimbursement. Collaborate with billing, AR, prior authorization, and clinical teams to resolve coding and documentation issues. Monitor coding trends, provide insights, and support audits and quality reviews to improve outcomes. Stay current with coding updates, payer requirements, and healthcare regulations while maintaining HIPAA compliance.

Pay:

$20.00 - $25.00 per hour

Benefits:

Health insurance Paid time off

Work Location:

In person